重危血气胸患者行胸腔闭式引流的临床疗效分析

Clincal efficacy analysis of serious hemopnemothorax treated with thoracic closed drainage

目的探讨重危胸部创伤血气胸行胸腔闭式引流的疗效。方法回顾性分析1969年至2006年重危胸部创伤合并血气胸或血性心包进行胸腔闭式引流1 155例,总结相关病例及临床资料,观察和分析胸腔闭式引流的疗效。结果1 155例病例中行开胸手术270例,非开胸手术885例,临床治愈1 000例(治愈率86.6%),死亡155例(死亡率13.4%),远期并发症335例(并发症率29.0%)。结论不同肋间胸腔闭式引流与死亡率没有直接关系,但与远期并发症有关。引流位置越低,远期并发症越少,在腋后线第8肋间隙进行胸腔闭式引流效果最好。

Objective To explore the curative efficacy of serious hemopneumothorax treated with thoracic closed drainage. Methods Total 1 155 cases of serious hemopneumothorax or hemopericardial treated with thoracic closed drainage were retrospectively analyzed from 1969 to 2006. Results Total 270 cases were performed thoracotomy, 885 cases with non-thoracic surgery. The rate of clinical cure was 86. 6% （1 000 cases）, case fatality was 13.4% （155 cases）. The occurrence rate of long-term complication was 29.0% （335 cases）. Conclusion Different intercostal spaces for thoracic closed drainage have no relation to mortality, but have relation to long-term complication. Drainaging in lower position, the fewer long-term complications happen. Drainage in the posterior axillary line of the 8th intercostal space is best.