三通阀联合中心静脉导管引流恶性积液的临床观察

Clinical Observation of Three-way Valve Combination with Central Venous Catheter on Drainage of Malignant Effusions

目的探讨三通阀联合中心静脉导管治疗恶性胸腹腔积液的临床效果。方法选取2011年1月至2013年1月邢台市第一医院收治的36例中等至大量恶性胸腹腔积液患者作为研究对象,采用三通阀联合中心静脉导管引流胸腹腔积液并进行药物治疗,观察患者的治疗效果及不良反应发生情况,比较患者治疗前后的生活质量。结果患者1次置管成功率为100%,胸腔积液引流平均时间为(4.0±2.0)d,腹腔积液引流平均时间为(7.0±2.0)d;患者出现引流管堵塞4例、胸腹腔穿刺点处轻微疼痛2例、恶心呕吐1例,腹痛1例。经1个月的治疗,临床治疗的总有效率为80.56%,生活质量改善的总有效率为86.11%。结论三通阀联合中心静脉导管治疗胸腹腔积液具有创伤小、操作简单、安全有效、不良反应少等优点,具有较高的临床实用价值。

Objective To discuss the clinical effect of three-way valve joint central venous catheter in treatment of malignant pleural effusion/abdominal cavity effusion. Methods A total of 56 seroperitoneum or hydrothorax patients admitted to the First Hospital of Xingtai between Jan. 2011 to Jan. 2013, the three-way valve joint central venous catheter was used for drainage followed by drug treatment. The curative effect and adverse reaction were observed,and the quality of life of patients before and after treatment was compared. Results The success rate of one-time catheter placement was 100% ,average pleural effusion drainage time was （4.0 ± 2.0 ）d on average, average seroperitoneum effusion drainage time was （7.0 ± 2.0 ） d. Drainage tube blockage was encountered in 4 cases, mild pain in 2 cases, nausea and vomiting in 1 case, abdominal pain in 1 case. After 1 month of treatment, the clinical effect of total effective rate was 80.56%, the improve- ment rate of quality of life was 86. 11%. Conclusion Three-way valve combination with central venous catheter for treatment seroperitoneum or hydrothorax is featured with small trauma, simple operation, safe and effective, and less adverse reaction, which has high clinical practical value.