中心静脉导管持续胸腔闭式引流在儿童结核性胸膜炎中的应用

Application of continuous thoracic close drainage using central venous catheter in the treatment of tuberculous pleurisy in children

目的探讨中心静脉导管持续胸腔闭式引流替代反复多次胸腔穿刺抽液治疗儿童结核性胸膜炎的效果。方法在常规抗结核化疗的基础上,观察组(39例)患儿采取中心静脉导管持续胸腔闭式引流治疗,对照组(42例)采用反复多次胸腔穿刺抽液治疗,观察并比较两组患儿胸腔积液吸收时间、胸膜肥厚情况、住院时间、穿刺相关费用等。结果中心静脉导管持续胸腔闭式引流组和反复多次胸腔穿刺抽液组相比,胸腔积液吸收加快(8±4 d vs 12±6 d,P<0.01),胸膜肥厚情况改善更好(1.50±0.25 mm vs 3.10±0.30 mm,P<0.05),住院时间缩短(11±3 d vs 18±6 d,P<0.01),穿刺相关费用降低(269±24元vs 475±50元,P<0.05),患儿痛苦减轻。结论中心静脉导管持续胸腔闭式引流治疗儿童结核性胸膜炎较反复多次胸腔穿刺抽液优势明显,适合在儿科临床中推广应用。

Objective To study the clinical effect of continuous thoracic close drainage using central venous catheter instead of repeated thoracocentesis in the treatment of tuberculous pleurisy in children. Methods Thirty-nine children with tuberculous pleurisy, who received continuous thoracic close drainage using central venous catheter in addition to conventional antituberculous chemotherapy, were used as the observation group and 42 children with tuberculous pleurisy who underwent repeated thoraeocentesis in addition to conventional antituberculous chemotherapy served as the control group. The two groups were compared in terms of time to pleural effusion absorption, improvement in pleural thickening, length of hospital stay, and puncture-related expenses. Results Compared with the control group, the observation group had significantly faster pleural effusion absorption （8±4 d vs 12±6 d; P 〈 0.01 ）, significantly more improvement in pleural thickening （ 1.50 ±0.25 mm vs 3.10 ± 0.30 mm; P 〈 0.05 ）, a significantly shorter length of hospital stay （ 11±3 d vs 18 ＋ 6 d ; P 〈 0.01 ）, and significantly lower puncture-related expenses （269± 24 yuan vs 475±50 yuan; P 〈 0.05 ）, as well as alleviated pain. Conclusions Continuous thoracic close drainage using central venous catheter is superior to repeated thoracocentesis in the treatment of tuberculous pleurisy in children, and it holds promise for clinical application in pediatric patients.