蕈状尿管在胸腔闭式引流术治疗自发性气胸中的应用研究.docVIP

蕈状尿管在胸腔闭式引流术治疗自发性气胸中的应用研究 　　摘要：目的 探讨以蕈状尿管作胸腔闭式引流管的方法治疗自发性气胸与传统硅胶管作闭式引流管在疗效、并发症方面的差异。方法 选择我院住院的已确诊的自发性气胸患者80例患者作为研究对象，其中40例采用蕈状尿管作胸腔闭式引流管（实验组），40例采用传统硅胶管作闭式引流管方法（对照组）。结果 两组患者的拔管时间、引流管移位率及引流不畅发生率相似。实验组术后疼痛严重者比例及术后皮下气肿发生率较对照组明显降低，两组间差异均有统计学意义（P0.05）。结论 采用蕈状尿管作胸腔闭式引流管的方法治疗气胸与传统硅胶管作胸腔闭式引流管的方法相比疗效相似，术后疼痛及皮下气肿较轻，值得临床推广。 　　关键词：蕈状尿管；自发性气胸；胸腔闭式引流 　　Abstract：Objective To explore the effect of the mushroom-shape urinary canal as drainage tube and the conventional drainage tube used in closed drainage of thoracic cavity in the treatment of spontaneous pneumothorax.Methods Eighty cases of spontaneous pneumothorax patients in our hospital were randomly divided into the observation group and control group，and there were 40 cases in each group.The observation group was used mushroom-shape urinary canal，while the control group was only received conventional drainage tube.All the cases were given closed drainage of thoracic cavity.Results All patients drainage tube removal time and aversion rate and inadequate drainage rate were resemblance.The pain and the cutaneous emphysema after operation of the observation group were lower than control group and the differences were statistically significant （P0.05）.Conclusion The difference was not statistically significant in the mushroom-shape urinary canal as drainage tube and the conventional drainage tube，but the pain and the cutaneous emphysema after operation of the observation group were lower than control group.It is worth further clinical application. 　　Key words：Mushroom-shape urinary canal；Spontaneous pneumothorax；Closed drainage of thoracic cavity 　　自发性气胸为常见的胸外科危重急症 ，临床上男性患者较为多见。自发性气胸分为原发性自发气胸和继发性自发气胸，发病原因是由肺组织和脏层胸膜因原有某种病变或缺陷突然破裂而导致的胸腔积气。自发性气胸严重时可导致呼吸和循环系统衰竭，危及患者生命健康，所以该病需尽早采取积极干预治疗措施[1]。气胸常用的治疗方法包括：保守治疗、胸腔穿刺抽气、胸腔闭式引流术 、胸膜粘连术和外科手术治疗等[2]。我科2012年1月～2014年9月采用蕈状尿管作为胸腔闭式引流管治疗自发性气胸患者40例取得较好疗效，现报道如下。 　　1资料与方法 　　1.1一般资料 选取2012年1月～2014年9月在我院住院的已确诊的自发性气胸患者80例为研究对象。所有对象自发病到就诊时间为1 h～2 d，均通过胸部x线或CT检查证实为自发性气胸，肺组织压缩在40%以上，均行闭式引流治疗，排除：双侧