超声引导胸腔穿刺置管引流治疗复杂性肺炎旁胸腔积液及脓胸的价值

Value of chest drainage tube guided by ultrasound in the treatment of complexity pneumonia pleural effusion and pyothorax

目的探讨超声引导穿刺一次性置管在治疗复杂性肺炎旁胸腔积液及脓胸的临床价值。方法选择2009年1月～2011年12月本院收治21例CPE及5例TE患者,CPE与TE并存同时置入两侧导管5例。应用常规介入超声方法,一次性穿刺置入猪尾型多孔导管,腔内注射糜蛋白酶和尿激酶冲洗治疗,TE注入庆大霉素和甲硝唑注射液冲洗治疗。结果 26例超声引导一次性穿刺置管成功率100%,均无并发症发生,CPE引流48h,临床症状明显改善,TE48h退热。结论超声引导穿刺一次性置管引流治疗具有安全、简便、易行、重复性强等优点,克服以往置管操作繁琐的弊端,是CPE和TE治疗的有效手段,尤其便于基层应用,值得推广。

Objective To explore the clinical value of chest drainage tube guided by ultrasound in the treatment of complexity pneumonia pleural effusion and pyothorax. Methods From January 2009 to December 2011,CPE 21 cases and 5 cases with TE,and 5 eases with CPE and TE coexist at the same time put catheter in both sides in our hospital.The pig tail type porous tubes wered one-time punctured into by conventional interventional ultrasound method,intracavitary injection of urokinase and chymotrypsin washing treatment,washing treatment TE injection of gentamicin and metronidazole. Results The one-time puncture and put catheter guided by ultrasound success rate of 26 cases was 100%,and no complications occurred,CPE drainage for 48 hours,the clinical symptoms improved obviously,antifebrile after TE 48 hours. Conclusion Chest drainage tube guided by ultrasound has the advantages of safe,simple,easy,strong repeatability,to overcome the malady of tedium and complexity in previous operation,is an effective method for CPE and TE treatment, especially for basic applications,is worth promoting.