中心静脉导管加注入尿激酶胸腔闭式引流堵管率及耐受性观察

Incidence Rate of Bunging and Tolerance of Closed Drainage of Thoracic Cavity with Urokinase in Douching of Central Venous Catheter

目的比较中心静脉导管加注入尿激酶与常规胸腔闭式引流胸腔积液的堵管发生率及患者耐受性。方法选取2009年10月—2012年8月住院部确诊的胸腔积液73例,分为3组,实验一组21例采用胸腔留置单腔中心静脉导管,实验二组18例采用留置中心静脉导管加每日尿激酶10万单位注入胸腔,对照组34例采用留置常规胸腔插管闭式引流,比较3组患者治疗1周后的堵管率、耐受性。结果实验一组、二组堵管率分别为42.9%(9/21)和27.8%(5/18),对照组为14.7%(5/34)。实验一组显著高于对照组(χ2=5.422,P=0.020)。实验一、二组总体耐受性满意率92.3%显著高于对照组55.9%(χ2=12.973,P=0.000),实验组耐受性好。结论尿激酶在减少胸腔闭式引流管堵管率上有一定作用。患者对中心静脉导管的耐受性要好于常规置管。

Objective To compare the incidence rate of bunging and tolerance for pleural effusion by closed drainage of thoracic cavity between central venous catheter with Urokinase douching and routine method. Methods A total of 73 inpatients with pleural effusion during October 2009 and August 2012 were divided into three groups. Patients in group A （n = 21 ） were inserted central venous catheter; patients in group B （n = 18） were indwelled the same central venous catheter and injected 10wu urokinase into pectoral cavity everyday; patients in control group （n = 34） received routine intrathoracic cannula of closed drainage. After treatment for one week, the incidence rate of bunging and tolerance in three groups were compared. Results The incidence rates of bunging in group A and B, and control group were 42.9% （9/21）, 27.8% （5/18） and 14.7% （5/34） respectively, and which in group A was significantly higher than that in control group （X2 =5.422,P =0. 020）. The total rate of tolerance （92.3%） in group A and B （55.9%） was significantly higher than that in control group （ X2= 12. 973 ,P = 0. 000） , which showed that group A and B had better tolerance. Conclusion Urokinase has some action in reduction of incidence rate of bunging in closed drainage of thoracic cavity. Patients^tolerance by using central venous catheter is better than by using routine thoracic close drainage.