摘要
目的总结分析单腔中心静脉导管应用于中青年首次单侧自发性气胸患者中的疗效及价值。方法回顾性分析2013年1月—2017年6月浙江中医药大学附属第一医院接受住院诊治的首次发生单侧自发性气胸中青年患者的临床资料,共计纳入115例研究对象。根据气胸治疗方法的异同,将研究对象分为3组,即行单腔中心静脉导管接水封瓶行胸腔闭式引流术组(A组)45例,单纯性胸腔留置中心静脉导管抽气组(B组)36例,传统的胸腔闭式引流术组(C组)34例。比较分析3组间疗效及胸膜反应、堵管、脱管、感染、出血、皮下气肿、疼痛、漏气等并发症方面的差异。结果单腔中心静脉导管接水封瓶行胸腔闭式引流术组(A组)、单纯性胸腔留置中心静脉导管抽气组(B组)、传统的胸腔闭式引流术组(C组)治疗有效率分别为97.78%、100.00%、97.06%,3组有效率比较,差异无统计学意义(P>0.05)。A组、B组、C组总并发症发生率分别为6.67%、5.56%、32.35%。A、B组的并发症发生率明显低于C组,差异均有统计学意义(均P<0.05)。结论单腔中心静脉导管在中青年首次单侧自发性气胸患者中具有重要的应用价值,其疗效与传统的胸腔闭式引流术接近,但是并发症发生率明显降低,并且具有创伤小、操作简单、患者容易接受等众多优点,其在临床中的应用价值尚值得进一步总结研究。
Objective To evaluate the efficacy and value of a single -lumen central venous catheter in the treatment of the first unilateral spontaneous pneumothorax in young- and middle-aged patients. Methods The clinical data of 115 young- and middle-aged patients with developed first unilateral spontaneous pneumothorax in our hospital between January, 2013 and June, 2017 were retrospectively analyzed. The patients were divided into three groups based on the different treatment styles. Group A （ n = 45 ） underwent the placement of a single-lumen central venous catheter connect- ed to a water seal bottle and cured with closed thoracic drainage ; Group B （ n = 36） received single-lumen central venous catheter to extract gas ; and group C （ n = 34） underwent traditional thoracic closed-chest drainage. The differences in therapeutic effects and complications including pleural reaction, blockage, lumen loss, infection, bleeding, subcutaneous emphysema, pain, air leakage among the three groups were analyzed. Results The effective rate was 6.67%, 5.56%, 32.35 % in group A, group B and group C, respectively, there was no significant differences （P 〉 0.05）. The total inci- dence of complications of groups A, B, and C were 97.78% , 100.00%, and 97.06% , respectively. The incidence in groups A and B were significantly lower than that in group C, and the difference was statistically significant （P 〈 0.05）. Canclusian The single -lumen central venous catheter has important application in young- and middle-aged patients with first unilateral spontaneous pneumothorax. Its curative effect rate is similar to that of traditional thoracic closed-chest drainage, but the total incidence of complications is significantly lower. Besides, it has many advantages such as small wound, simple operation and easy accepted by patients, and its application value in clinic is worth further study.
作者
鞠方鹤
王真
肖祖克
JU Fang-he;WANG Zhen;XIAO Zu-ke(Department of Respiratory Medicine, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou , Zhejiang 310006, China)
出处
《中华全科医学》
2018年第5期729-731,共3页
Chinese Journal of General Practice
基金
浙江省自然基金资助项目(LY18H270011)
浙江中医药大学科研基金项目(2015ZY03)
关键词
单腔中心静脉导管
气胸
闭式引流
Single-lumen central venous catheter
Pneumothorax
Closed-chest drainage
