闭式引流联合胸膜固定术与单纯闭式引流治疗自发性气胸的效果分析

Effect analysis of closed drainage combined with pleurodesis and closed drainage alone in the treatment of spontaneous pneumothorax

目的探讨闭式引流联合胸膜固定术与单纯闭式引流治疗自发性气胸的效果。方法选取2014年2月~2016年4月我院收治的76例自发性气胸患者为研究对象,依据治疗措施不同分为单纯组(单纯闭式引流治疗)38例和联合组(闭式引流联合胸膜固定术治疗)38例。观察两组自发性气胸患者术后漏气时间、术后引流量、术后置管时间、术后住院时间、临床疗效、复发率、术后疼痛程度和并发症情况。结果联合组术后漏气时间[(43.6±4.2)min]、术后置管时间[(4.1±0.6)d]、术后住院时间[(5.0±0.8)d]均短于单纯组[(52.9±4.8)min、(7.5±1.1)d、(5.9±1.0)d],术后引流量(192.4±9.0)ml多于单纯组的(180.2±8.7)ml;联合组临床治疗总有效率为94.7%,高于单纯组的73.7%,复发率(5.3%)低于单纯组的26.3%;联合组术后疼痛程度优于单纯组;联合组并发症发生率(5.3%)低于单纯组的26.3%,差异有统计学意义(P<0.05)。结论闭式引流联合胸膜固定术治疗自发性气胸患者引流效果好,恢复快,预后良好,值得临床推广应用。

Objective To explore the effect of closed drainage combined with pleurodesis and closed drainage alone in the treatment of spontaneous pneumothorax.Methods 76 patients with spontaneous pneumothorax treated in our hospital from February 2014 to April 2016 were selected as research object.According to the different therapeutic measures,they were evenly divided into lonely group （closed drainage alone for treatment） and combined group （closed drainage com- bined with pleurodesis）.The postoperative leakage time,postoperative drainage volume,postoperative catheterization time, hospital stay after surgery,clinical efficacy,recurrence rate,postoperative pain and complications were observed between two groups.Results In the combined group,the postoperative leakage time,postoperative catheterization time,and hospital stay after surgery was （43.6±4.2） rain,（4.1±0.6） d,and （5.0±0.8） d,which was shorter than that in the lonely group,with （52.9± 4.8） min,（7.5±1.1） d,and （5.9±1.0） d in turn.The postoperative drainage volume in the combined group was （192.4±9.0） ml, more than that in the lonely group of （180.2±8.7） ml.The total clinical therapeutic effective rate was 94.7%,more than that of the lonely group （73.7%）.The recurrence rate and incidence of complications in the combined group were both 5.3%,while in the lonely group,they were both 26.3%,the indexes in the former group were lower.The postoperative pain in the combined group was superior to that in the lonely group.All these mentioned above were displayed statistical sig- nificance after comparisons （P〈0.05）.Conclusion Combination of closed drainage and pleurodesis in the treatment of spon- taneous pneumothorax patients has advantages of great effect on drainage,fast recovery,and favorable prognosis,which is worthy of clinical application and promotion.