Closed thoracic drainage in elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax:A retrospective study

BACKGROUND Chronic obstructive pulmonary disease(COPD)combined with spontaneous pneumothorax,is characterized by significant decline in lung function,and even cause cardiopulmonary failure and hypoxia.AIM To evaluate the clinical effectiveness of central venous catheters and indwelling pleural catheters(IPC)in managing closed thoracic drainage in patients diagnosed with COPD with concomitant by spontaneous pneumothorax.METHODS Retrospective analysis was conducted on the clinical information of 60 elderly patients with COPD complicated by spontaneous pneumothorax admitted to the Shexian Branch of the second affiliated hospital of Zhejiang university school of medicine between March 2020 and March 2023.The clinical efficacy,complications,hospitalization duration,and costs were compared between patients with an indwelling thoracic catheter and those with a central venous catheter.Univariate logistic regression was used to analyze the causes of catheter displacement.RESULTS According to our findings,there were significant differences in the IPC group’s clinical efficacy,catheter operation time,and lung recruitment time(P<0.05).Comparing the complications after catheter treatment between the two groups revealed statistically significant variations in the incidence of postoperative analgesics,catheter abscission,catheter blockage,and subcutaneous emphysema in the IPC group(P<0.05).Univariate analysis demonstrated significant differences between patients with and without catheter dislodgement regarding duty nurse’s working years(less than three),Acute Physiology and Chronic Health Evaluation II(APACHE II)scores(less than 15),lack of catheter suture fixation,and the proportion of catheters not fixed twice(P<0.05).CONCLUSION Our results demonstrated that when treating elderly COPD patients with spontaneous pneumothorax,indwelling thoracic catheters are more effective than the central venous catheter group.Patients’catheter shedding is influenced by the primary nurse’s working years,APACHE II scores,and catheter fixation technique.

Management of traumatic hemothorax by closed thoracic drainage using a central venous catheter

Objective:To evaluate the efficacy and safety of the treatment of traumatic hemothorax by closed pleural drainage using a central venous catheter(CVC),compared with using a conventional chest tube.Methods:A prospective controlled study with the Ethics Committee approval was undertaken.A total of 407 patients with traumatic hemothorax were involved and they were randomly assigned to undergo closed pleural drainage with CVCs(n=214) or conventional chest tubes(n=193).The Seldinger technique was used for drainage by CVC,and the conventional technique for drainage by chest tube.If the residual volume of the hemothorax was less than 200 ml after the daily volume of drainage decreased to below 100 ml for two consecutive days,the treatment was considered successful.The correlative data of efficacy and safety between the two groups were analyzed using t or chi-squared tests with SPSS 13.0.A P value of less than 0.05 was taken as indicating statistical significance.Results:Compared with the chest tube group,the operation time,fraction of analgesic treatment,time of surgical wound healing,and infection rate of surgical wounds were significantly decreased(P<0.05) in the CVC group.There were no significant differences between the two groups in the success rate of treatment and the incidence of serious complications(P>0.05),or in the mean catheter/tube indwelling time and mean medical costs of patients treated successfully(P>0.05).Conclusions:Management of medium or large traumatic hemothoraxes by closed thoracic drainage using CVC is minimally invasive and as effective as using a conventional large-bore chest tube.Its complications can be prevented and it has the potential to replace the large-bore chest tube.

Indwelling catheter and conservative measures in the treatment of abdominal compartment syndrome in fulminant acute pancreatitis

AIM： To study the effect of combined indwelling catheter, hemofiltration, respiration support and traditional Chinese medicine （e.g. Dahuang） in treating abdominal compartment syndrome of fulminant acute pancreatitis. METHODS： Patients with fulminant acute pancreatitis were divided randomly into 2 groups of combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring and routine conservative measures group （group 1） and control group （group 2）. Routine non-operative conservative treatments including hemofiltration, respiration support, gastrointestinal TCM ablution were also applied in control group patients. Effectiveness of the two groups was observed, and APACHE Ⅱ scores were applied for analysis. RESULTS： On the second and fifth days after treatment, APACHE Ⅱ scores of group 1 and 2 patients were significantly different. Comparison of effectiveness （abdominalgia and burbulence relief time, hospitalization time） between groups 1 and 2 showed significant difference, as well as incidence rates of cysts formation. Mortality rates of groups 1 and 2 were 10.0% and 20.7%, respectively. For patients in group 1, celiac drainage quantity and intra-abdominal pressure, and hospitalization time were positively correlated （r = 0.552, 0.748, 0.923, P 〈 0.01） with APACHE Ⅱ scores. CONCLUSION： Combined indwelling catheter celiac drainage and intra-abdominal pressure monitoring, short veno-venous hemofiltration （SVVH）, gastrointestinal TCM ablution, respiration support have preventive and treatment effects on abdominal compartment syndrome of fulminant acute pancreatitis.

Thoracic duct cannulation during left internal jugular vein cannulation:A case report

BACKGROUND Central venous catheter insertion is an invasive procedure that can cause complications such as infection,embolization due to air or blood clots,pneumothorax,hemothorax,and,rarely,chylothorax due to damage to the thoracic duct.Herein,we report a case of suspected thoracic duct cannulation that occurred during left central venous catheter insertion.Fortunately,the patient was discharged without any adverse events related to thoracic duct cannulation.CASE SUMMARY A 46-year-old female patient presented at our department to undergo cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.During anesthesia,we decided to insert a central venous catheter through the left internal jugular vein because the patient already had a chemoport through the right central vein.During the procedure,blood reflux was observed when the needle tip was not within the ultrasound field of view.We did not try to find the tip;however,a guide wire and a central venous catheter were inserted without any resistance.Subsequently,when inducing blood reflux from the distal port of the central venous catheter,only clear fluid,suspected to be lymphatic fluid,was regurgitated.Further,chest X-ray revealed an appearance similar to that of the path of the thoracic duct.Given that intravenous fluid administration was not started and no abnormal fluid collection was noted on preoperative chest X-ray,we suspected thoracic duct cannulation.CONCLUSION It is important to use ultrasound to confirm the exact position of the needle tip and guide wire path.

Pneumothorax Complicating Port-a-Cath and Groshong Catheter Positioning in Children: Our Experience before Routine Ultrasound-Guided Puncture

Objective: To study incidence and management of long term central venous catheter (CVC) placement related pneumothorax (PNX) in children. Aim: To construct a baseline value before the introduction of systematic use of ultrasound guidance, which requires specific training and equipment. Background: Anesthesia Service and Pediatric Oncology of the Italian National Cancer Center;patients were children (age ≤ 18 years) with solid tumors, needing long-term central venous catheters (Groshong or Port-a-Cath). Materials/Methods: Catheter placement was performed, mostly under general anesthesia, utilizing a micropuncture 5-7 Fr needle and fluoroscopy. In the study period ultrasound was used only in case of previously failed attempts. Relevant data were collected retrospectively. Results: From August 2008 to December 2011, 452 catheters were implanted to our patients. The prevalent approach was from subclavian vein (left 85.7%, right 9.7%);in few cases internal jugular vein was chosen (right 2.4%, left 2.2%). Pneumothorax occurred in 14 patients (3.1%;95%CI 1.9-5.1). In 4/14 children the PNX was considered minimal and not treated. In 10 patients the PNX was drained. In 7 cases a traditional, surgical thoracostomy was performed, while in 3 children a 14-Ga polyurethane catheter (Arrow International&#174) was inserted over a wire guide in the pleural space by anaesthetists. Conclusions: In our centre rates of PNX are the same as those described in literature and are expected to lower when ultrasound guidance of the puncture will be routinely applied. Percutaneous drainage of PNX seems as effective as surgically placed thoracostomy catheter, but less invasive.

Pleural drainage following total cavopulmonary connection in the era of central venous catheter

Background Pleural effusion after the Fontan operation contributes significantly to morbidity and prolonged hospitalization. The purpose of the present study was to investigate whether chest tubes placed in different cavities during the surgery would contribute to the drainage and also to evaluate risk factors of thoracic drainage with central venous catheter after total cavopulmonary connection in the era of the central venous catheter. Methods From January 2009 to June 2012, 109 consecutive patients underwent total cavopulmonary connection at Guangdong General Hospital. With 102 patients for investigation, preoperative, intraoperative and postoperative factors were obtained. Thoracic drainage with central venous catheter was whenever necessary. Duration of chest tube drainage and time of thoracic drainage with central venous catheter added up to total duration of pleural drainage. Binary logistic regression using forward LR method was applied for the analysis of the risk factors for thoracic drainage with central venous catheter. Results After total cavopulmonary connection, compared with chest tubes placed in single pleural cavity with or without pericardial or retrosternal cavity, those in both pleural cavities seemed to have the chance of longer hospital stay （P = 0.028）. No other significant differences were obtained in factors of ventilation time, extubated central venous pressure in superior vena cava, ICU stay, total duration of pleural drainage. Sildenafil was the preventive factor for reducing central venous pressure and preventing from postoperative pleural effusion. Conclusions After total cavopulmonary connection, patients with tubes placed in both pleural cavities would not have the chance of shorter total duration of pleural drainage and surprisingly turns out to have longer hospital stay. Sildenafil is a preventive factor for thoracic drainage with central venous catheter.

不同导管胸膜腔置管闭式引流治疗自发性气胸疗效比较

目的:比较不同导管胸膜腔置管闭式引流治疗自发性气胸疗效。方法:选取新乡市第一人民医院2018年9月至2023年9月收治的90例自发性气胸患者作为研究对象,应用随机数字表法将其分为三组,即中心静脉导管组、胸腔引流管组与三腔气囊导尿管组,各组均为30例。所有患者均采取胸膜腔置管闭式引流术进行治疗,三组患者分别采取中心静脉导管、胸腔引流管和三腔气囊导尿管进行引流。比较三组患者临床疗效,置管时疼痛发生率、置管时出血量、二次置管率与调整引流管率,平均切口大小、肺复张时间、置管时间、住院时间,术后疼痛程度,术后并发症发生情况。结果:胸腔引流管组和三腔气囊导尿管组的总有效率高于中心静脉导管组;中心静脉导管组和三腔气囊导尿管组患者置管时疼痛发生率、二次置管率与调整引流管率以及置管时出血量均明显低于胸腔引流管组;中心静脉导管组患者平均切口大小明显短于三腔气囊导尿管组和胸腔引流管组,且三腔气囊导尿管组短于胸腔引流管组;术后1 d、3 d、5 d,中心静脉导管组和三腔气囊导尿管组患者的视觉模拟评分法(VAS)评分明显低于胸腔引流管组,中心静脉导管组和三腔气囊导尿管组切口感染、肺水肿/皮下气肿、胸膜反应发生率明显低于胸腔引流管组;差异均具有统计学意义(P<0.05)。结论:采取胸腔引流管与三腔气囊导尿管进行胸膜腔置管闭式引流治疗自发性气胸疗效优于中心静脉导管,而应用中心静脉导管和三腔气囊导尿管患者置管时疼痛发生率较低,能够降低二次置管率、创伤性较低,降低术后疼痛程度,减少并发症发生率。

中心静脉导管胸腔闭式引流术与胸腔穿刺抽液术在结核性胸膜炎患者中的应用效果分析

目的:对比中心静脉导管(CVC)胸腔闭式引流术(TCD)与胸腔穿刺抽液术治疗结核性胸膜炎(TBP)患者的效果。方法:回顾性选取2020年1月至2023年6月濮阳市第五人民医院60例TBP患者病例资料,按手术方案不同分为两组。以接受CVC-TCD治疗的30例患者列为A组,以接受胸腔穿刺抽液术治疗的30例患者列为B组。对比两组手术效果、围术期指标、术前、术后14 d CD4^(+)/CD8^(+)炎性因子[干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、γ-干扰素诱导蛋白10(IP-10)]、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平、并发症发生率。结果:A组手术优良率96.67%(29/30)相较于B组73.33%(22/30)更高(P<0.05);A组胸液吸收时间、退热时间相较于B组更短,胸膜厚度、抽液总量相较于B组更低(P<0.05);A组术后14 d血清IFN-γ、TNF-α、IP-10水平相较于B组更低(P<0.05);A组术后14d CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平相较于B组更高(P<0.05);A组并发症发生率3.33%(1/30)相较于B组26.67%(8/30)更低(P<0.05)。结论:与胸腔穿刺抽液术治疗TBP患者相比,经CVC-TCD治疗可进一步提升手术效果,优化围术期指标,缓解机体炎性反应状态,提高免疫功能,降低并发症发生风险。

胸腔穿刺置管联合持续负压吸引治疗微波消融肺结节所致气胸

目的观察胸腔穿刺置管联合持续负压吸引治疗微波消融(MWA)肺结节所致气胸的价值。方法回顾性分析21例肺结节经MWA后出现气胸而接受胸腔穿刺置管联合持续负压吸引治疗患者,观察胸腔穿刺置管联合持续负压吸引的疗效及安全性。结果胸腔穿刺置管联合持续负压吸引成功率和有效率均为100%(21/21)。胸腔积液发生率为14.29%(3/21),咯血发生率为9.52%(2/21),未见其他并发症。治疗后3个月,肺结节病灶71.43%(15/21)完全缓解,28.57%(6/21)部分缓解,总有效率和局部控制率均为100%(21/21)。结论胸腔穿刺置管联合持续负压吸引治疗MWA肺结节所致气胸安全、有效。

中心静脉导管持续引流肿瘤相关性腹水管理的最佳证据总结

目的检索、评价并总结中心静脉导管持续引流肿瘤腹水管理的最佳证据,为临床优化导管引流管理提供参考。方法系统检索UptoDate、BMJ最佳临床实践、JBI循证卫生保健中心数据库、PubMed、Cochrane Library、医脉通、中国知网等数据库中关于中心静脉导管持续引流肿瘤相关性腹水导管的指南、系统评价、专家共识、临床决策和随机对照试验等。2名研究者进行文献质量评价和资料提取,并结合专业人员的判断,进行证据汇总。结果共纳入12篇文献,其中临床决策1篇,专家共识3篇,系统评价1篇,随机对照试验6篇,队列研究1篇。汇总了关于中心静脉导管引流肿瘤腹水管理的23条证据,包括评估、腹水引流调节装置、导管固定、敷料、冲管和封管、导管堵塞处理、腹水渗漏预防处理、并发症处置及健康教育9个方面。结论总结中心静脉导管持续引流肿瘤相关性腹水管理的证据,为临床医护人员实施中心静脉导管引流腹水以及优化导管引流管理提供循证依据。

ICU中应用中心静脉导管行胸腔闭式引流治疗气胸的疗效观察

目的观察和评价应用中心静脉导管行胸腔闭式引流治疗ICU中突发气胸的临床疗效。方法将62例在ICU治疗过程中发生气胸的患者随机分为中心静脉引流管组（n=32）和传统引流管组（n=30），常规治疗原发病的基础上，两组按不同方法行胸腔闭式引流治疗，分析比较两组患者的临床疗效、医疗费用及并发症。结果与传统引流管组比较，中心静脉引流管组患者从确诊气胸至呼吸窘迫缓解的时间及手术操作时间明显缩短（均P〈0．01），创伤口直径、出血量、疼痛程度及此操作的医疗费用明显减少（均P〈0．01），而肺复张时间相对延长（P〈0．01），但留管时间两组比较差异无统计学意义（P〉0．05）。在并发症方面，中心静脉引流管组患者的置管不适、胸膜反应及复张性肺水肿的发生率较传统引流管组明显减少（均P〈0．05），而皮下气肿、血胸、伤口感染、堵管及再置管的发生率两组比较差异无统计学意义（均P〉0．05）。另外，两组患者气胸的治愈率比较差异也无统计学意义（P〉0．05）。结论在ICU应用中心静脉导管置管行胸腔闭式引流治疗突发气胸安全、简便，并发症及医疗费用少，疗效肯定。

留置中心静脉导管加注入尿激酶治疗结核性包裹性胸腔积液疗效观察

目的探讨用中心静脉导管胸腔置管持续引流加胸腔注入尿激酶治疗结核性包裹性胸腔积液的疗效。方法结核性包裹性胸腔积液病人60例,随机分为引流组及穿刺组,每组30例。引流组胸腔内注射50ml生理盐水加尿激酶100,000U;穿刺组胸腔内注射50ml生理盐水加地塞米松10mg。两组均按同样方案抗结核治疗,比较两组治疗疗效。结果引流组胸腔积液引流量平均为2134±203ml,显著多于穿刺组的1356±213ml(P<0.05);治疗后胸膜厚度为2.78±0.24mm,显著低于穿刺组3.24±0.29mm(P<0.05);且肺功能指标明显优于穿刺组(P<0.05),住院时间明显缩短。结论中心静脉导管加注入尿激酶治疗结核性包裹性胸腔积液疗效显著。

中心静脉导管置管引流治疗危重患者胸腔积液的效果及安全性观察

目的探讨中心静脉导管置管引流治疗危重患者胸腔积液的效果及安全性。方法采用前瞻性研究方法，将2010年9月至2011年10月本院重症医学科46例有胸腔积液危重患者，根据原发病类别配对分成传统胸腔闭式引流组（对照组）和中心静脉导管置管引流组（观察组）两组进行胸腔引流，每组23例。比较两组患者引流效果和并发症；术前及术后24 h检测急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、胸腔积液定量、白细胞计数（WBC）、血小板计数（PLT）、凝血酶原时间（PT）、降钙素原（PCT）和C-反应蛋白（CRP）等指标。结果两组患者胸腔积液引流量、置管治疗时间比较差异均无统计学意义，两组治疗前后APACHEⅡ评分、胸腔积液定量、WBC、PLT、PT、PCT比较差异也均无统计意义（均P＞0.05）；观察组术后CRP水平（μg/L）较对照组明显降低（77.26±67.20比106.13±66.23，P＜0.01）。对照组并发症发生率虽高于观察组（26.1%比4.3%），但差异无统计学意义（P＞0.05）。结论采用中心静脉导管置管引流治疗危重患者胸腔积液的疗效与传统治疗相当，术后患者应激较轻且并发症较少，是一种可以替代传统胸腔闭式引流术安全、有效的治疗胸腔积液的方法。

中心静脉导管胸腔闭式引流联合胸腔内灌注香菇多糖注射液治疗结核性胸腔积液的疗效观察

目的探讨中心静脉导管胸腔闭式引流联合胸腔内灌注香菇多糖注射液治疗结核性胸腔积液的疗效。方法将84例结核性胸腔积液患者随机分为治疗组和对照组,每组42例。治疗组给予中心静脉导管胸腔闭式引流联合胸腔内注入香菇多糖注射液进行治疗,对照组给予单纯中心静脉导管胸腔闭式引流进行治疗。结果治疗组治愈率为97.62%,显著高于对照组80.95%,差异有统计学意义(P<0.05)。结论中心静脉导管胸腔闭式引流联合胸腔内注入香菇多糖注射液治疗结核性胸腔积液疗效确切,能有效缩短疗程,且不良反应轻微,值得临床推广。

中心静脉导管骶前留置在直肠癌术后吻合口瘘中的应用及护理

目的：总结中心静脉导管骶前留置用于直肠癌术后吻合口瘘病人的护理体会。方法2008年6月～2012年4月，对21例直肠癌术后吻合口瘘患者在C T定位下经臀部置入中心静脉导管骶前留置引流，对患者加强导管护理，注重心理护理及营养护理。结果21例患者经充分引流，17～46 d瘘口均愈合，其中2例患者出现置管口旁蜂窝组织炎；3例导管阻塞，用导丝或生理盐水冲管后复通；1例脱管重新置管。结论中心静脉导管骶前引流在直肠癌术后吻合口瘘治疗中是一种安全、损伤小、病人舒适度较高的方法，减少了二次手术率。

不同管径闭式引流管用于气胸患者胸腔闭式引流术治疗的临床疗效及对患者疼痛评分的影响

目的分析传统硅胶引流管、中心静脉引流管用于气胸患者胸腔闭式引流术治疗的临床效果与对患者术后疼痛评分的影响。方法前瞻性分析2018年7月至2020年11月廊坊市人民医院行胸腔闭式引流术患者60例,采用随机数字表法将患者分为A组30例、B组30例。A组采用中心静脉导管进行术后引流,B组采用传统硅胶胸管用于手术引流。观察2组患者气胸治疗效果,围术期各项指标及术后生活活动能力指数、疼痛评分情况。结果A、B组治疗总有效率分别为93.33%、86.67%,2组总有效率比较,差异无统计学意义(P>0.05)。A组与B组肺复张时间比较[(2.45±0.61)d vs.(2.58±0.67)d],差异无统计学意义(P>0.05);A组伤口愈合时间、住院时间分别为(6.08±1.35)、(5.03±1.28)d,显著短于B组[(6.88±1.31)、(5.87±1.39)d],差异有统计学意义(P<0.05)。引流15 d后,A组Barthel指数为(70.3±10.2)分显著高于B组[(58.3±8.7)分],视觉模拟疼痛评分为(2.02±0.05)分,显著低于B组[(3.78±1.03)分],差异有统计学意义(P<0.05)。结论中心静脉导管引流用于气胸患者胸腔闭式引流术与传统硅胶胸管引流临床疗效并无差异,但前者患者术后伤口愈合更快、住院时间更短,生活活动能力更强,疼痛越轻。

中心静脉导管闭式引流治疗自发性气胸的临床分析

目的:探讨中心静脉导管闭式引流治疗自发性气胸的临床效果。方法:采用美国ARROW公司生产的中心静脉导管对自发性气胸患者进行胸腔闭式引流并与粗硅胶管组进行比较,治疗组30例自发性气胸患者行中心静脉导管闭式引流,对照组27例行粗硅胶管闭式引流,观察疗效及并发症。结果:治疗组总有效率93.3%,对照组总有效率96.3%,中心静脉导管与粗硅胶管行胸腔闭式引流治疗自发性气胸疗效相近,无显著性差异(P>0.05);但粗硅胶管行胸腔闭式引流治疗并发症多,镇痛药使用率高(51.9%)。结论:中心静脉导管行闭式引流治疗自发性气胸是一种痛苦小,并发症少,住院费用少,操作简单,舒适耐受的方法。

腹腔引流导管用于胸腔闭式引流治疗胸腔积液的临床疗效分析

目的比较腹腔引流导管进行胸腔闭式引流术与一次性使用中心静脉导管胸腔闭式引流术在治疗胸腔积液病人的疗效,为推广腹腔引流导管进行胸腔闭式引流术治疗胸腔积液提供依据。方法以2014年3月至2016年12月就诊的171例胸腔积液患者为研究对象。将其随机分为观察组和对照组,对照组83例,采用一次性使用中心静脉导管进行胸腔闭式引流;观察组88例,采用腹腔引流导管进行胸腔闭式引流。对比观察两组的临床疗效、并发症、引流时间、手术时间及住院时间。结果与对照组比较,观察组显效率(85.2%)和总有效率(96.6%)明显高于对照组(74.7%,89.2%),而且皮下气肿数(0例)和堵管数(2例)明显少于对照组(3例,6例),差异均有显著性(P<0.05)。其它观察指标两组间无显著差异(P>0.05)。结论腹腔引流导管作胸腔闭式引流术在治疗胸腔积液方面临床疗效优于中心静脉导管,而且具有堵管率低、皮下气肿发生率低等优势。

不同术式胸腔闭式引流术治疗自发性气胸的疗效观察

目的观察4种不同术式胸腔闭式引流术治疗初发自发性气胸的疗效及并发症。方法初发自发性气胸146例,根据不同术式胸腔闭式引流分为4组,开花引流管组、带针胸导管组、中心静脉导管组及猪尾巴引流导管组,进行回顾性对比分析,比较各组临床疗效、肺膨胀时间、疼痛程度及并发症。结果中心静脉导管组疗效较低,但与其他组比较差异无统计学意义(P>0.05)。肺膨胀时间特别在<36 h、>120 h时间段,猪尾巴引流导管组与开花引流管组、带针胸导管组比较差异无统计学意义(P>0.05),与中心静脉导管组比较差异有统计学意义(P<0.05)。疼痛程度比较,疼痛程度≥7的小口径引流管组(中心静脉导管组与猪尾巴引流导管组)与大口径引流管组(开花引流管组与带针胸导管组)比较差异有统计学意义(P<0.01)。并发症发生率猪尾巴引流导管组较其他各组明显减少,差异有统计学意义(P<0.05)。结论采用猪尾巴引流导管组做胸腔闭式引流术治疗初发自发性气胸,具有微创、效优,并发症少等特点,值得临床推广应用。

中心静脉管穿刺置管负压吸引治疗气胸临床对照观察

目的：考察中心静脉穿刺管留置胸腔，外接负压引流治疗气胸的临床应用效果。方法因气胸在我科住院的87例患者随机分为2组：实验组，即中心静脉管穿刺置管负压吸引组，38例；对照组，即传统胸腔粗管闭式引流组，49例。采用肺复张时间和治疗期间疼痛指数作为评价指标。结果实验组肺复张时间和治疗期间疼痛指数均明显优于对照组（P＜0．01）。结论中心静脉管穿刺置管外接负压吸引与传统胸腔粗管闭式引流比较具有明显的优越性，可作为治疗气胸的首选治疗手段。