中心静脉导管治疗自发性气胸临床分析.docVIP

中心静脉导管治疗自发性气胸临床分析【摘要】目的:探讨中心静脉导管进行胸腔闭式引流治疗自发性气胸的临床效果。方法:中心静脉导管对自发性气胸患者进行胸腔闭式引流并与普通28号硅胶管组进行比较,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 例行普通硅胶管闭式引流, 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%,中心静脉导管与普通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（P0.05）;但普通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。 【关键词】自发性气胸; 中心静脉导管; 胸腔引流 【中图分类号】R561.4【文献标识码】A【文章编号】1008-6455（2011）04-0341-02 Clinical Analysis of Central Venous Catheter for Treating Spontaneous Pneumothorax Wang Bin1 Wang Xiaoli1 Zhang Youguo 【Abstract】Objective: To summarize the clinical effective in treating the spontaneous pneumothorax of using central venous catheter .Methods: The curative effects and complications in treating the spontaneous pneumothorax by thoracic close drainage of central venous catheter with by normal silica gel catheter were compared. Thirty cases of spontaneous pneumothorax had the thoracic close drainage of the central venous catheter，while twenty seven cases in the same condition had the thoracic close drainage of the normal silica gel catheter .Results：In treat group total effective rate was 93.3%，while in control group total effective rate was 96.3%. Their curative effects were similar without obvious differences，but the thoracic close drainage of the normal silica gel catheter had more complications and higher usage of pain relief medicine. Conclusion: The treatment of spontaneous pneumothorax through the thoracic close drainage of the central venous catheter is satisfactory remedy with fewer complications and cost of hospitalization. It is more simple and comfortable. 【Key words】spontaneous pneumothorax；central venous catheter；Chest drainage 自发性气胸是较为常见的胸腔疾病, 也是胸外科最常见的急诊病例之一。胸腔闭式引流术是治疗自发性气胸的重要措施,常规的胸腔闭式引流术多采用胸壁切口置入普通硅胶引流管进行引流,但较易出现皮下气肿、切口感染、胸腔积液、复张性肺水肿、出血等并发症,且术后患者经常出现持续切口疼痛以及胸背部疼痛以至不敢深呼吸影响肺复张,手术后活动不便,愈合后遗留疤痕,患者往往难以接受。我科自2007年1月至2010年10月采用中心静脉导管治疗自发性气胸,并与传统的胸壁切口切置入普通硅胶引流管行闭式引流作比较,该手术方式简单易行,不良反应小,疗效满意,报告如下： 1 资料与方法 1.1 临床资料:病例来源于2007年1月至2010年10月在