中心静脉导管在小儿肺炎旁胸腔积液中的应用价值

Application Value of Pediatric Parapneumonic Pleural Effusion Using a Central Venous Catheter

目的探讨中心静脉导管在小儿肺炎旁胸腔积液(PPE)治疗中的价值及安全性。方法将68例经超声确诊为中或大量PPE的患儿,随机分成两组:治疗组(n=34例)行中心静脉导管持续胸腔闭式引流,对照组(n=34例)行传统胸腔穿刺引流,比较两组胸腔积液的引流量、退热时间、气促改善时间、胸水吸收时间、住院时间等。结果治疗组的引流量、气促改善时间、胸水吸收时间、住院时间、病原诊断率优于对照组,组间比较差异有统计学意义。治疗组的退热时间、并发症、不良反应与对照组比较差异无统计学意义。结论中心静脉导管持续胸腔闭式引流是一种操作简单、效果好、损伤小且安全的治疗方法,尤其值得在儿科推广。

Objective To investigate the efficacy and safety of the treatment of pediatric parapneumonic pleural effusion by closed pleural drainage using a central venous catheter, compared with using a conventional thoracentesis. Methods 68 cases with Medium or large parapneumonic pleural effusion diagnosed by chest ultrasound were randomly divided into two groups： the patients in treatment group（ n = 34） were undergone by persistently closed pleural drainage using a central venous catheter. The patients in control group（ n=34 ） were drainaged by conventional thoracentesis, the drainage fever clearance time, shortness of breath improve pleural fluid absorption time, hospitalization time of two groups were compared. Results The drainage, shortness of breath improve time and the time of pleural effusion absorption of the treatment group were better than those of the control group, there were significant differences between the two groups, but there was no significant difference in fever clearance time. Conclusion Central venous catheter closed thoracic drainage was an effective and injury treatment worthy of promotion in pedi- atrics.