静脉留置针穿刺胸腔闭式引流治疗新生儿气胸的临床观察

Closed thoracic drainage by venously indwelling catheter for neonatal pneumothorax

目的探讨采用静脉留置针穿刺胸腔闭式引流对新生儿气胸进行治疗的临床效果。方法随机选取2013年4月至2015年1月期间我院收治的气胸新生儿44例，按照治疗方案的不同将其分为对照组和观察组，其中观察组患儿进行静脉留置针胸腔穿刺闭式引流，对照组患儿采用传统外科置管闭式引流进行治疗，对两组患儿治疗前后的影像学、血氧饱和度、临床表现变化进行观察记录。结果两组患儿治疗结束时，其血氧分压[（68．2±8．9）mmHg，（66．5±9．2）mmHg）]、血二氧化碳分压[（34．7±1．9）mmHg，（34．5±2．1）mmHg）]相比并无明显差异（P〉0．05）；观察组患儿的呼吸机使用时间[（4．3±1．1）d）]、诊断距治疗完成时间[（16．7±4．4）min]均明显短于对照组患儿[（6．4±1．7）d、（40．9±7．4）min]，差异具有统计学意义（P〈0．05）。结论采用静脉留置针穿刺胸腔闭式引流术对新生儿气胸进行治疗，效果显著，可有效改善患儿的呼吸状况，且操作简便，便于实施，建议在临床进一步推广。

Objective To explore the clinical effect of closed thoracic drainage by venously indwelling catheter for neonatal pneumothorax. Methods 44 patients with neonatal pneumothorax admitted into our hospital from July, 2013 to February, 2015 were randomly selected and were divided into an observation group and a control group according to different treatment regimens. The observation group was treated with closed thoracic drainage by venously indwelling catheter and the control group with closed drainage by traditional surgical catheter. The changes in imaging, blood oxygen saturation, clinical manifestations of both groups before and after the treatment were observed and recorded. Results By the end of the treatment, there were no statistical differences in partial pressure of oxygen [（68.2±8.9） mmHg vs. （66.5±9.2） mmHg] and PCO2[（34.7±1.9） mmHg vs. （34.5±2.1） mmHg] between these two groups（P〉0.05）; the respirator support time and the time from diagnosis to the end of the treatment were significantly shorter in the observation group than in the control group[（4.3±l.1） d vs. （6.4±1.7） d and （16.7±4.4） min vs. （40.9±7.4） min, P〈0.05]. Conclusions Closed thoracic drainage by venously indwelling catheter neonatal pneumothorax is significantly effective, can effectively improve the patient＇s respiratory status, and is easy in operation and implementation, so it should be clinically generalized.