闭氏引流管引流与常规穿刺引流对小儿胸腔积液的临床疗效对比

Comparison of clinical efficacy between closed drainage tube and conventional puncture drainage in treatment of pleural effusion in children

目的比较闭氏引流管引流与常规穿刺引流对小儿胸腔积液治疗的临床疗效。方法选择河北省民政总医院儿科2014年8月-2018年3月治疗的肺部感染所致胸腔积液患儿120例为研究对象,随机分为对照组和观察组,每组60例,观察组患儿采用胸腔闭氏引流管胸腔积液引流技术进行治疗,对照组患儿采用常规穿刺引流技术治疗,对比分析2组患儿的治疗效果、临床症状改善情况、并发症、免疫功能以及炎性因子水平之间的差异。结果与对照组比较,观察组患儿总有效率(98.33%)升高,退热时间、住院时间、气促改善时间、胸腔积液消退时间、堵管率和皮下气肿率均降低,差异存在统计学意义(P<0.05)。与治疗前比较,2组患儿治疗后血清CD3+、CD4+、CD8+水平、IgA、IgM、IgG、CD4+/CD8+比值均升高,差异均有统计学意义(P<0.05);与对照组治疗后比较,观察组治疗后患儿血清CD3+、CD4+、CD8+水平、IgA、IgM、IgG、CD4+/CD8+比值均升高,差异均有统计学意义(P<0.05)。与治疗前比较,2组患儿治疗后炎性因子TNF-α、IL-6、IL-8水平均下降,差异均有统计学意义(P<0.05)。与对照组治疗后比较,观察组治疗后患儿炎性因子TNF-α、IL-6、IL-8水平均下降,差异均有统计学意义(P<0.05)。与对照组比较,观察组患儿堵管率和皮下气肿率均降低,差异有统计学意义(P<0.05)。结论闭氏引流管引流可改善胸腔积液患儿的临床症状,降低堵管率以及皮下气肿率,临床疗效显著。

Objective To compare the clinical efficacy of closed drainage tube and conventional puncture drainage in children with pleural effusion. Methods A total of 120 children with pleural effusion caused by pulmonary infection treated in the Department of Pediatrics of Hebei Civil Affairs General Hospital from August 2014 to March 2018 were randomly divided into observation group and control group, with 60 cases for each group. The observation group was treated with closed thoracic drainage tube and pleural effusion drainage technology, while the control group with conventional puncture and drainage. The difference of therapeutic effect, clinical symptoms improvement, complications, immune function and levels of inflammatory factors between the two groups were compared and analyzed. Results Compared with the control group, the total effective rate in the observation group increased by 98.33%, and the antipyretic time, hospital stay time, improvement time of shortness of breath, pleural effusion subside time, rate of tube blockage and subcutaneous emphysema decreased with statistical significance(P<0.05). Compared with before the treatment, the serum levels of CD3+, CD4+, CD8+, IgA, IgM, IgG and CD4+/CD8+ in the two groups increased significantly after the treatment(P<0.05);compared with the control group, the serum levels of CD3+, CD4+, CD8+, IgA, IgM and CD4+/CD8+ in the observation group increased significantly after the treatment, and the differences were significant(P<0.05). Compared with before the treatment, the levels of inflammatory factors TNF-α, IL-6 and IL-8 in the two groups decreased after the treatment, and the differences were statistically significant(P<0.05). Compared with the control group, the levels of inflammatory factors TNF-α, IL-6 and IL-8 in the observation group decreased after the treatment, and the differences were statistically significant(P<0.05). Compared with the control group, the rate of tube blockage and subcutaneous emphysema in the observation group were lower, and the differences were statistically significant(P<0.05). Conclusion Closed drainage tube can improve the clinical symptoms of children with pleural effusion, reduce the rate of obstruction and subcutaneous emphysema. The clinical effect is remarkable.