改良胸腔闭式引流在肺大泡自发性气胸治疗中的应用

Application of Modified Thoracic Closed Drainage in the Treatment of Spontaneous Pneumothorax in Pulmonary Bullae

目的探讨改良胸腔闭式引流治疗肺大泡自发性气胸的临床疗效与安全性。方法方便选取2014年3月—2018年3月该院呼吸内科56例行胸腔闭式引流的肺大泡自发性气胸患者为研究对象,依据引流方法不同分为实验组(中心静脉置管胸腔闭式引流,28例)和对照组(常规胸腔闭式引流,28例),对比观察两组疗效,统计并发症。结果两组一次穿刺置管成功率均为100.00%,实验组治疗有效率(96.43%)与对照组(92.86%)差异无统计学意义(χ2=2.037,P>0.05)。实验组置管操作时间(5.1±1.6)min,切口愈合时间(3.1±0.7)d,术后疼痛3.57%,皮下血肿0.00%,感染0.00%,各项指标均低于对照组,差异有统计学意义(t=4.113,t=4.850,χ2=7.135,χ2=4.209,χ2=4.612;P<0.05)。结论中心静脉置管胸腔闭式引流治疗肺大泡自发性气胸效果确切,可早期有效缓解患者症状,且适应性好,痛苦小,并发症少,值得临床推广使用。

Objective To evaluate the clinical efficacy and safety of modified thoracic closed drainage for spontaneous pneumothorax of pulmonary bullae.Methods From March 2014 to March 2018,56 patients with pulmonary pneumothorax spontaneous pneumothorax who underwent closed thoracic drainage in the hospital were conveniently enrolled in the study.According to different drainage methods,the patients were divided into experimental group (central venous catheter closed thoracic cavity drainage,28 cases) and control group (conventional thoracic closed drainage,28 cases),contrast observation of the two groups of efficacy,statistical complications.Results The success rate of one puncture catheter was 100.00% in both groups.There was no significant difference between the experimental group (96.43%) and the control group (92.86%)(χ^2=2.037,P>0.05).The operation time of the experimental group was (5.1±1.6)min,the healing time of the incision was (3.1±0.7)d,the postoperative pain was 3.57%,the subcutaneous hematoma was 0.00%,the infection was 0.00%,and the indexes were lower than the control group,with academic significance (t=4.113,t=4.850,χ^2=7.135,χ^2=4.209,χ^2=4.612; P<0.05).Conclusion Central venous closed thoracic drainage for the treatment of spontaneous pneumothorax in pulmonary bullae is effective,can effectively relieve the symptoms of patients early,and has good adaptability,less pain,less complications,and is worthy of clinical promotion.