气胸患者胸腔闭式引流置管部位的选择：锁骨中线第2肋间还是安全三角区

Where to place closed thoracic drainage tubes in pneumothorax patients：the second intercostal space at the midclavicular line or the safe triangle

目的探讨安全三角区在气胸患者胸腔闭式引流术中的临床应用价值。方法82例拟行胸腔闭式引流术的气胸患者，选择穿刺置管部位时采取随机双盲法分为安全三角区组及常规部位组（锁骨中线第2肋间），其中安全三角区组39例，常规部位组43例。两组均按标准胸腔闭式引流术规程进行操作。记录两组胸壁厚度、置管时间、总操作时间、患者面部表情疼痛评分（FPRS）、术中出血情况及术后并发症等。结果与常规部位组比较，安全三角区组胸壁厚度较薄，置管时间及总手术时间缩短，术中疼痛较轻（P〈0．05）。术中出血量两组问比较差异无统计学意义。安全三角区组均1次置管成功。常规部位组有2次置入失误。结论安全三角区做为胸腔闭式引流术的置管部位，较常规锁骨中线第2肋间更具优势。适宜作为气胸胸腔置管闭式引流术的首选置管部位。

Objective To assess the application of placement of closed thoracic drainage tubes in the safe triangle area for pneumonthorax patients. Methods A total of eighty-two pneumonthorax patients who were to undergo closed thoracic drainage were enrolled. They were randomly divided into two groups according to their insertion sites： a safe triangle area group （39 cases） and a conventional site group （the second intercostal space at the midclavicular line, 42 cases）. Both groups underwent surgery and then compared for the thickness of the chest wall, the time of tube placement, total operation time, face pain rating score （FPRS）, bleeding during surgery and complications after surgery. Results Compared with the conventional site group, the safe triangle area group has the thinner chest wall and produced shorter time of tube placement, reduced total time of operation, with less pain （P 〈0.05）. There was no statistical difference as to volumes of bleeding between the two groups. Tube placement was successfully in all patients of the safe triangle group, while two failed cases were recorded in the conventional group. Conclusions The safe triangle area is more suitable to place closed drainage tubes, compared with the second intercostal space at the midclavieular line, which is the first choice of placement site for closed thoracic drainage in pneumonthorax patients.