探讨中心静脉置管引流治疗胸腔积液危重患者的临床疗效及安全性

Clinical efficacy and safety of central venous catheter tube drainage in treatment of critically ill patients with pleu-ral effusion

目的：观察中心静脉置管引流治疗胸腔积液危重患者的临床疗效。方法选取胸腔积液危重患者92例作为研究对象，采用掷骰子方法将患者分为对照组和观察组，对照组行传统胸腔引流，观察组行中心静脉置管引流，观察穿刺前和穿刺中血压、心率变化，行急性生理学与慢性健康状况评分系统Ⅱ（ APACHE）评分，评估两组疗效。结果观察组治疗有效率为97．83％，显著高于对照组（84．78％），差异有统计学意义（P＜0．05）。观察组穿刺中舒张压、收缩压和心率分别为（85．26±11．36）mm Hg、（119．22±12．69）mm Hg、（112．54±12．05）次／min，显著高于对照组，差异有统计学意义（P＜0．05），与术前比较差异未见统计学意义（P＞0．05）。 APACHE评分为（25．51±4．20）分，显著低于对照组，差异有统计学意义（P＜0．05）。结论中心静脉置管引流具有安全性高的特点，可减少对胸腔积液危重患者心率、血压的影响，有利于提高临床疗效。

Objective To observe the clinical curative effect of central venous catheter tube drainage on critically ill patients with pleural effusion.Methods Ninty-two critically ill patients with pleural effusion treated in the hospital were chose as research objects, the patients were divided into control group and observation group, control group underwent conventional thoracic drainage, observation group had central venous catheter drainage, the changes of blood pressure, heart rate were observed before puncture and biopsy, and chronic health Evaluation II study for acute physiology score （ A-PACHE） , the effects of the two groups were evaluated.Results The effective rate of the treatment in observation group was 97.83%, which was significantly higher than that in the control group （84.78%）, there was significant difference （P〈0.05）.The observation group puncture in diastolic and systolic blood pressure and heart rate were （85.26＋11.36） mm Hg, （119.22＋12.69） mm Hg, （112.54＋12.05） /min, which was significantly higher than those in the control group, there were significant differences （P〈0.05）, compared with the preoperative, there was no significant difference （P＆gt;0.05）.A-PACHE score （25.51 ＋4.20） was significantly lower than that of the control group, there was significant difference （ P〈0.05）.Conclusions Central venous catheter drainage has high safety, which can reduce the effect on heart rate and blood pressure in critically ill patients with pleural effusion, and is conducive to enhance the clinical curative effect.