带针胸管胸腔闭式引流在慢性阻塞性肺疾病合并自发性气胸患者中的应用效果

Effect of thoracic closed drainage with needle chest tube applied to chronic obstructive pulmonary disease complicated with spontaneous pneumothorax

目的观察带针胸管胸腔闭式引流在慢性阻塞性肺疾病(COPD)合并自发性气胸(SP)患者中的应用效果。方法将75例COPD合并SP患者分为普通硅橡胶胸管组(A组)、中心静脉导管组(B组)和带针胸管组(C组),每组25例,分别采用普通硅橡胶胸管、中心静脉导管及带针胸管进行胸腔闭式引流术。观察3组患者的临床指标和并发症发生情况。结果 3组治愈率比较,差异无统计学意义(P>0.05)。3组手术时间、肺复张时间、引流时间及术后住院时间比较,差异均有统计学意义(均P<0.05),其中A组手术时间均长于B组及C组(均P<0.05),而B组与C组手术时间比较,差异无统计学意义(P>0.05);B组肺复张时间、引流时间及术后住院时间均长于A组及C组(均P<0.05),而A组与C组肺复张时间、引流时间及术后住院时间比较,差异均无统计学意义(均P>0.05)。3组总并发症发生率比较,差异有统计学意义(P<0.05),其中C组总并发症发生率低于A组(P<0.05),而A组与B组、B组与C组总并发症发生率比较,差异均无统计学意义(均P>0.05);A组伤口感染发生率均高于B组与C组(P<0.05),而B组堵管发生率高于A组(P<0.05)。结论采用带针胸管进行胸腔闭式引流治疗COPD合并SP临床效果确切,并发症发生率低。

Objective To observe the effect of thoracic closed drainage with needle chest tube applied to chronic obstructive pulmonary disease（ COPD） complicated with spontaneous pneumothorax（ SP）. Methods Seventy-five patients with COPD complicated with SP were divided into general silicone rubber chest tube group（ group A）,central venous catheter group（ group B） and needle chest tube group（ group C）according to the treatment method,with 25 cases in each group. The three groups used common silicone rubber chest tube,central venous catheter and needle chest tube,respectively,for thoracic closed drainage. The clinical indexes and the incidence of complications were observed in the three groups. Results There was no significant difference in the cure rate among the three groups（ P〉 0. 05）. There were statistically significant differences in the operation duration,lung recruitment duration,drainage duration and postoperative hospital stay among the three groups（ all P 〈0. 05）,and the operation duration in group A was longer than that in group B or group C（ all P 〈0. 05）,but there was no statistically significant difference in the operation duration between group B and group C（ P 〉0. 05）; the lung recruitment duration,drainage duration and postoperative hospital stay in group B were longer than those in group A and group C（ all P 〈0. 05）,but no statistically significant difference was found in the lung recruitment duration,drainage duration or postoperative hospital stay between group A and group C（ all P 〉0. 05）.There was a significant difference in the incidence rate of overall complications among the three groups（ P〈 0. 05）,and the incidence rate of overall complications in group C was lower than that in group A（ P 〈0. 05）,but there was no statistically significant difference in the incidence rate of overall complications between group A and group B,or between group B and group C（ all P〉 0. 05）. The incidence rate of wound infection in group A was higher than that in group B or group C（ P〈 0. 05）,while the incidence rate of tube plugging in group B was higher than that in group A（ P 〈0. 05）. Conclusion Thoracic closed drainage with needle chest tube has a define clinical efficacy for COPD complicated with SP and a low incidence rate of complications.