中心静脉导管胸腔闭式引流联合持续负压吸引治疗慢性阻塞性肺疾病并自发气胸的临床分析

Clinical analysis of combined continuous negative pressure suction of central venous catheter combined with continuous negative pressure suction in the treatment of chronic obstructive pulmonary disease and spontaneous pneumothorax

目的探讨、分析应用中心静脉导管实行胸腔闭式引流联合持续负压吸引对慢阻肺并自发气胸患者的疗效及不良反应。方法在我院2011年1月-2015年1月收治的慢阻肺并自发气胸患者中选取48例,依照随机原则,将患者分为治疗组和对照组,每组24例。治疗组应用中心静脉导管实行胸腔闭式引流联合持续负压吸引,对照组应用粗硅胶导管实行胸腔闭式引流。记录、观察两组患者治疗后肺复张情况、肺复张时间及不良反应。结果治疗组有效率91.67%,平均肺复张时间(5.2±2.0)天,对照组有效率95.83%,平均肺复张时间(4.8±2.2)天,两组有效率和肺复张时间比较(P>0.05),无统计学意义;但治疗组和对照组比较,胸膜反应、切口感染、皮下气肿、胸痛的发生率明显降低(P<0.05),有统计学意义。结论应用中心静脉导管胸腔闭式引流联合持续负压吸引对慢阻肺并自发气胸患者而言,操作简单、疗效显著、不良反应小,值得临床进一步推广。

Objective To investigate the efficacy and side effect of combined continuous negative pressure suction with central venous catheters in the treatment of chronic obstructive pulmonary disease and spontaneous pneu -mothorax.Methods From January 2015 to January 2011, 48 patients with chronic obstructive pulmonary disease and spontaneous pneumothorax were selected , and they were randomly divided into the treatment group and the con-trol group, 24 cases in each group.The treatment group was treated with central venous catheter combined with con -tinuous negative pressure drainage , and the control group was treated with the treatment of the thoracic cavity closed drainage with crude silica gel .After treatment , their lung recruitment , lung recruitment time and adverse reactions were observed in the two groups .Results The effective rate of the treatment group was 91.67%, and the average time of lung recruitment was （5.2 ±2） days.In control group, the effective rate was 95.83%, and the average time of lung recruitment was （4.8 ±2.2） days.There was no significant difference in efficiency and lung recruitment time （P〉0.05）.But the incidence of adverse reactions such as pleural reaction , wound infection, subcutaneous emphy-sema and chest pain was lower in the observation group than in the control group （ P〈0.05） .Conclusion Central venous catheter combined with continuous negative pressure suction drainage has the advantages of simple operation , good efficacy , few adverse reactions in the treatment of chronic obstructive pulmonary disease and spontaneous pneu -mothorax, which is worthy of widely clinical promotion .