摘要
目的探究胸腔镜下自体血经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)导管瘘口注射封堵术在难治性气胸患者中的应用效果与安全性。方法选取2015年3月至2017年11月宁波市第七医院的72例难治性气胸患者为研究对象,将其根据治疗方式的不同分为对照组(高渗葡萄糖胸膜固定术组)36例和观察组(胸腔镜下自体血经PICC导管瘘口注射封堵术组)36例。比较两组的临床治疗效果、不良反应发生率、不同时间的复发率、治疗前后的气促分级、血气分析结果及应激相关指标。结果观察组的总有效率为97.22%,高于对照组的80.56%(χ~2=5.063,P=0.024),不良反应发生率为11.11%低于对照组的44.44%(χ~2=9.969,P=0.001),治疗后3、6、12个月的复发率分别为0%、0%及2.78%,低于对照组的11.11%、13.89%及16.67%(χ~2=4.235、5.373、3.956,P=0.039、0.020、0.046),治疗后的气促分级、血气分析结果及应激相关指标均优于对照组,差异有统计学意义(P均<0.05)。结论胸腔镜下自体血经PICC导管瘘口注射封堵术在难治性气胸患者中的应用效果较好,安全性也较高,在难治性气胸患者中的应用价值较高。
Objective To discuss the effect and safety of the application of thoracoscopic closure with autologous blood by fistula of PICC catheter in patients with refractory pneumothorax.Methods 72 patients with refractory pneumothorax treated in our hospital from March 2015 to November 2017 were enrolled and were divided into control group(36 cases)and observation group(36 cases).Patients in the control group received pleura fixation with hypertonic glucose treatment,while those in the observation group received thoracoscopic closure with autologous blood by fistula of PICC catheter treatment.The therapeutic effect,adverse reaction rate,recurrence rate,polypnea classification,blood gas analysis and stress related index were compared between the two groups.Results The overall effective rate was significantly higher in the observation group than that in the control group(97.22%vs 80.56%;χ~2=5.063,P=0.024),while the adverse reaction rate was significantly lower(11.11%vs 44.44%;χ~2=9.969,P=0.001).The recurrence rates in the observation group were 0%,0%and 2.78%at 3 nd,6 th and 12 th month after treatment,while they were 11.11%,13.89%and 16.67%in the control group,the differences were significant(χ~2=4.235,5.373,3.956,P=0.039,0.020,0.046).After the treatment,the polypnea classification,blood gas findings and stress related indices in the observation group were all superior than those in the control group(P<0.05).Conclusions The application of thoracoscopic closure with autologous blood by fistula of PICC catheter in patients with refractory pneumothorax is effective and safe.
作者
严东梅
王镇
侯诚
郑磊
YAN Dong-mei;WANG Zhen;HOU Cheng;ZHENG Lei(The Seventh Hospital of Ningbo,Ningbo,Zhejiang 315200,China;不详)
出处
《中国预防医学杂志》
CAS
CSCD
2020年第5期554-557,共4页
Chinese Preventive Medicine
基金
宁波市医学科技计划基金资助项目(2019Y41)
关键词
胸腔镜
自体血经PICC导管瘘口注射封堵术
难治性气胸
应用效果
安全性
血气分析
Thoracoscopic operation
Closure with autologous blood by fistula of PICC catheter
Refractory pneumothorax
Application effect
Safety
Blood gas analysis
