摘要
目的探讨微创胸腔置管并间歇抽气联合短暂高流量吸氧治疗原发性气胸的临床价值。方法60例患者均被确诊为原发性气胸，肺被压缩40％-90％，随机分为治疗组及对照组；治疗组30例，用双腔中心静脉导管（广东百合医疗科技有限公司生产）行微创胸腔置管，并间歇抽气联合短暂高流量吸氧治疗；对照组30例，行传统胸腔闭式引流术，并持续低流量吸氧治疗。观察两组治疗效果、并发症、住院时间、氧疗时间、氧疗费用。结果治疗效果比较：治疗组及对照组治愈率分别为93．3％和96．7％，两者比较，P值为1．000，差异无统计学意义；治疗组及对照组的肺完全复张时间分别为（3．9±0．9）天和（4．9±1．2）天，两组比较，差异有统计学意义（P〈0．05）。并发症比较：两组均未发生氧中毒、严重堵管、切口感染、复张性肺水肿；治疗组，皮下气肿、胸腔积液、剧烈胸痛发生率分别为0％、3．3％、0％，而对照组分别为20％、26．7％、40％，两组比较，差异有统计学意义（P〈0．05）。卫生经济学指标比较：治疗组的住院时间（4．4±0．7）天，氧疗总时间（3．1±0．5）小时，氧疗费用（18．5±3．1）元；对照组的住院时间（5．9±1．0）天，氧疗总时间（117．5±25．1）小时，氧疗费用（400．6±155．0）元；两组对比，差异有统计学意义（P〈0．05）。结论微创胸腔置管间歇抽气联合短暂高流量吸氧治疗原发性气胸的方法可以获得良好的治疗效果，操作简易，并发症少，易耐受，且经济、安全，值得临床推广应用。
Objective To investigate clinical value of minimally invasive pleural cathetering and interval air exhaust combined with transient high-flow oxygen in the treatment of primary pneumothorax. Methods The 60 patients were diagnosed as the primary pneumothorax, the hangs of the patients were compressed for 40%-90%, the patients were randomly divided into the treatment group and the control group; the treatment group was treated by minimally invasive pleural cathetering with double cavity central venous catheters （produced by the Baihe Medical Limited Company of Guangdong）and interval air exhaust combined with transient high-flow oxygen. The patients in the control group was treated by traditional closed thoracic drainage combined with continued low-flow oxygen. Then we observed the clinic effects, the complications, the time of the oxygen therapy, the cost of the oxygen therapy in two groups. Results The comparison of the therapeutic effect was as follows： the cure rate was 93.3% in the treatment group and 96.7% in the control group, P=1.000, it had no statistical significance; the time of the complete recruitment maneuvers was （3.9 ± 0.9） days in the treatment group and （4.9 ± 1.2） days in the control group, showing statistical significant difference, P 〈 0.05. The comparison of the complications：the oxygen poisoning, the severe tube plugging, the infection of operative incision, reexpansion puhnonary edema did not happen in the two groups; the incidence rates of the subcutaneous emphysema, the pleural effusion and the severe chest pain were 0%,3.3% and 0% respectively in the treatment group, but were 20%,26.7% and 40% respectively in the control group, showing statistical significant difference, P 〈 0.05. The comparison of the heahh economics indexes： in the treatment group, the hospital stays, the total time of the oxygen therapy and the cost of the oxygen therapy were （4.4 ± 0.7） days, （3.1 ± 0.5） hours, （18.5 ± 3.1） yuan respectively; in the control group those were （5.9 ± 1.0） days, （117.5 ± 25.1） hours and （400.6 ± 155.0） yuan respectively, with statistical significant difference, P 〈 0.05. Conclusion The method of minimally invasive pleural cathetering and interval air exhaust combined with transient high- flow oxygen in the treatment of primary pneumothorax could obtain good therapeutic effect, which is simple and easy for operation, with less complications and easy tolerance, it is economic and safe, worthy of promotion in clinic.
出处
《国际医药卫生导报》
2014年第19期2965-2968,共4页
International Medicine and Health Guidance News
关键词
微创胸腔置管
间歇性抽气
短暂高流量吸氧
原发性气胸
Minimally invasive pleural cathetering
Interval air exhaust
Transient high-flow oxygen
Primary pneumothorax
