深静脉导管置入在自发性气胸患者围手术期的应用

Application of deep venous catheterization in patients with spontaneous pneumothorax during the perioperative period

目的探讨深静脉导管置入在自发性气胸患者围手术期的应用。方法对48例自发性气胸患者术前予以深静脉导管持续引流气体,观察患者症状改善情况,术前胸部CT观察气胸吸收情况及肺大疱检出率,以及术后并发症的发生情况。结果 48例患者中40例患者症状改善明显,术前胸部CT发现44例压迫肺组织明显复张,46例发现肺大疱(阳性率95.83%),1例患者术后早期出现气胸复发,再次深静脉导管置入负压吸引后好转,所有患者无复张性肺水肿发生。结论深静脉导管置入在自发性气胸患者围手术期治疗中,操作简单、创伤小,提高术前肺大疱检出率,很好的提高了手术的安全性,有效的减少了术后气胸复发和复张性肺水肿的发生,值得临床推广应用。

Objective To observe the application of deep venous catheterization in patients with spontaneous pneumothorax during the perioperative period. Methods 48 patients with spontaneous pneumothorax were placed with deep venous catheter before operation to drain the gas constantly. The improvement in symptoms, absorption of gas examined by chest CT, detectable rates of pulmonary bulla and incidence of postoperative complications were observed. Results 40 patients＇ symptoms improved significantly and 44 cases of compressed lungs were inflated obviously examined by chest CT before operation. The pulmonary bulla were found in 46 cases （positive rate of 95.83 %）. 1 case occurred recurrence of pneumothorax in the early period after operation,and sympotms was improved after deep vein catheterization, accom- panied with negative pressure suction. No patient has been found to suffer from reexpansion pulmonary edema. Conclusion Deep venous catheterization in patients with spontaneous pneumothorax during the perioperative period has the advantages of easy use, lesser operative damage,high detectable rates of pulmonary bulla improving safety of operation, reducing recurrence of pneumothorax and reexpansion pulmonary edema.