胸腔闭式引流接负压吸引治疗原发性气胸的压力选择

OPTIMAL NEGATIVE PRESSURE FOR CLOSED THORACIC DRAINAGE COMBINED WITH NEGATIVE PRESSURE SUCTION IN TREATMENT OF PRIMARY PNEUMOTHORAX

目的探讨原发性气胸病人胸腔闭式引流同步接低负压治疗的可行性及最佳负压值。方法我院收治原发性气胸病人60例,入院后即行胸腔闭式引流并同步接符合胸膜腔生理的低负压持续吸引,按吸引负压值不同将其分为A组(-0.5kPa)、B组(-1.0kPa)、C组(-1.5kPa),观察3组病人中重度胸痛持续时间、气泡溢出时间、水柱显示恢复负压时间及胸管留置时间。结果 B、C组气泡溢出时间、水柱显示恢复负压时间及胸管留置时间均较A组明显减少,差异有统计学意义(F=3.504~4.068,P<0.05);3组胸痛持续时间比较差异无显著性(P>0.05);B组与C组各指标比较差异均无统计学意义(P>0.05)。结论胸腔闭式引流同步接-1.0、-1.5kPa的持续负压吸引效果优于-0.5kPa,能有效促进肺复张。

Objective To investigate the feasibility and optimal negative pressure for closed thoracic drainage combined with low negative pressure in the treatment of primary pneumothorax.Methods Sixty patients with primary pneumothorax who were admitted to our hospital were enrolled as subjects.Those patients received closed thoracic drainage combined with continuous low negative pressure suction immediately after admission.The patients were divided into group A（-0.5 kPa）,group B（-1.0 kPa）,and group C（-1.5 kPa）based on the value of negative pressure.The duration of moderate to severe chest pain,time to bubble overflow,time to recovery of negative pressure,and retention time of chest tube were observed in the three groups.Results Groups B and C had significantly shorter time to bubble overflow,time to recovery of negative pressure,and time to chest tube extraction than group A（F=3.504-4.068,P〉0.05）.There was no significant difference in the duration of chest pain between the three groups（P〈0.05）.There was no significant difference in any index between group B and group C（all P〉0.05）.Conclusion For closed thoracic drainage combined with continuous negative pressure suction,apressure of-1.0 or-1.5 kPa achieves better treatment outcomes than that of-0.5 kPa and effectively promotes pulmonary reexpansion.