中心静脉导管与双腔气囊尿管胸膜腔置管闭式引流治疗自发性气胸的对比分析

Comparative analysis of central venous catheter and double lumen balloon catheter in the treatment of spontaneous pneumothorax by percutaneous pleural catheterization and drainage

目的对比应用中心静脉导管和双腔气囊尿管经皮胸膜腔置管闭式引流在自发性气胸治疗中的应用效果。方法选择78例自发性气胸患者,随机分为观察组40例、对照组38例,观察组应用中心静脉导管经皮胸膜腔置管闭式引流治疗,对照组应用双腔气囊尿管经皮胸膜腔置管闭式引流治疗。观察并比较两组患者治疗效果、置管操作时间、置管时出血量、置管时疼痛发生率、置管后皮下气肿发生率、置管后脱管发生例数、置管后引流时间、患者住院时间。结果两组患者均一次性完成置管操作,观察组治疗成功37例(治愈35例、好转2例),对照组治疗成功36例(治愈30例、好转6例),两组比较差异无统计学意义(P>0.05)。观察组置管操作时间、置管时出血量、置管时疼痛发生率均小于对照组,差异有统计学意义(P<0.05),观察组置管后引流时间、患者住院时间短于对照组,差异有统计学意义(P<0.05),两组置管后皮下气肿及脱管发生例数比较差异无统计学意义(P>0.05)。结论中心静脉导管和双腔气囊尿管置管胸腔引流治疗自发性气胸均能取得良好的治疗效果,中心静脉导管胸膜腔置管引流治疗具有操作时间短、并发症少、住院时间短的优点,值得临床推广应用。

Objective To compare application effect of central venous catheter and double lumen balloon catheter in the treatment of spontaneous pneumothorax by percutaneous pleural catheterization and drainage. Methods 78 patients with spontaneous pneumothorax were randomly divided into observation group （n=40） and control group （n=38）. The observation group received treatment of central venous catheter percutaneous pleural catheterization and cavity arranged tube closed drainage, the control group received treatment of double lumen balloon catheter percutaneous pleural drainage. Observed and compared the treatment effect, intubation time, intubation bleeding, intubation pain occurrence rate and subcutaneous emphy-sema occurrence rate after intubation, catheter and intubation drainage time and dislodgement hospitalization time. Results Patients of two groups finished with one-time completion of catheterization operation. 37 cases were treated successfully （35 cases cured, 2 cases improved） in the observation group and 36 cases were treated successfully （30 cases cured, 6 cases improved） in the control group, the difference was not statistically significant （P〉0.05）. Intubation time and intubation bleeding, intubation pain occurrence rate in the observation group was less than that of the control group , the difference was statistically significant （P〈0.05）. The intubation drainage time and hospitalization time of the observation group was shorter than that of the control group, the difference was statistically significant （P〈0.05）. Subcutaneous emphysema occurrence rate after intubation and catheter dislodgement cases had no statistically significant difference （P〉0.05）. Conclusion Central venous catheter and double lumen balloon catheter in the treatment of spontaneous pneumothorax have good effect. Central venous catheter percuta-neous pleural catheterization and drainage has the advantages of short operation time , minor complications and short hospitaliza-tion time and is worth of clinical popularization application.