中心静脉导管对先天性心脏病术后胸腔积液应用价值

THE VALUE OF USING CENTRAL VENOUS CATHETERS FOR DRAINAGE OF PLEURAL EFFUSION AFTER SURGERY FOR CONGENITAL HEART DISEASE

目的 探讨中心静脉导管引流先天性心脏病术后胸腔积液的效果和安全性。方法 选取经胸片和超声诊断为胸腔积液的29例先天性心脏病术后病儿。通过床旁超声先行定位,局麻下置入中心静脉导管,观察治疗效果、不良反应,评估操作的安全性。结果 29例病儿均一次成功置入中心静脉导管,留置引流时间为3～24 d,累计引流量120～3 300 mL。所有病儿耐受性良好,临床症状明显改善,胸腔积液消失或减少,有效率达100%,未出现出血、气胸、导管脱出、感染、堵塞等相关并发症。结论 中心静脉导管引流先天性心脏病术后胸腔积液,具有简便、安全、有效、微创等特点,有较高的临床应用价值。

Objective To investigate the efficacy and safety of central venous catheter（CVC）drainage of pleural effusion after surgery for congenital heart disease（CHD）. Methods Using chest X-ray and ultrasonic diagnosis,29kids with pleural effusion after surgery for CHD were enrolled.Positioning was made first by bedside ultrasonography,and a CVC was inserted under local anesthesia.The treatment effectiveness and adverse reactions were observed,and the safety of the procedure assessed. Results All the CVCs were successfully inserted in one procedure,the tubes were dwelled for 3-24days and the accumulative total drainage volume was 120-3 300mL.All the kids were well-tolerated,clinical symptoms obviously improved along with disappearance or decrease of hydrothorax,effective power reaching 100%.No related complications,such as bleeding,pneumothorax,infections or blockage,were noted. Conclusion Central venous catheter drainage of pleural effusion after surgery for CHD has advantages of simple,safe,effective and minimally invasive,which possess higher value in clinical application.