经皮中心静脉导管胸腔闭式引流术的护理观察.docVIP

精品论文 参考文献 经皮中心静脉导管胸腔闭式引流术的护理观察 李玉松 曹建国 潘立东 　　（苍南县人民医院 浙江 苍南 325800） 　　【摘 要】目的：探讨中心静脉导管胸腔闭式引流治疗胸腔积液、积气的护理策略。方法：选取我科113例胸腔积液及气胸患者行闭式引流术前后的数据作为研究对象，其中53例采用中心静脉导管置入胸膜腔为研究组，另外60例使用传统硅胶管引流的为对照组，对护理方式、方法以及预防和减少护理并发症的措施进行总结。结果：两组患者的引流情况、并发症发生率、住院时间和住院总费用并没有明显差异，而在疼痛程度和局部反应的比较中，中心静脉导管引流组情况则明显优于传统胸腔闭式引流组。结论：中心静脉导管引流在胸腔积液及气胸治疗上临床效果好，操作简便、安全、经济、治愈率高、并发症少，能有效减少病人手术痛苦，值得在临床上推广应用。 　　【关键词】中心静脉导管；胸腔闭式引流；护理 　　【中图分类号】R472 【文献标识码】B 【文章编号】1004-6194（2015）01-0322-02 　　【Abstract】Objective：To investigate the thoracic close drainage of central venous catheter nursing strategy for the treatment of pleural effusion and pneumatosis.Methods：Select 113 cases in our Department of pleural effusion and pneumothorax were treated with closed drainage before and after data as the research object,of which 53cases were treated with central venous catheter indwelling pleural cavity as the study group, another 60 cases using traditional silicone tube drainage as control group on nursing ways and methods of preventing and reducing complications and nursing measures summary.Results：Complications of drainage, two groups of patients the incidence rate, hospitalization time and total cost of hospitalization and had no obvious difference, and in thecomparison of pain degree and local response, central venous catheter drainagegroup was significantly better than the traditional closed thoracic drainage group. Conclusion：The central venous catheter drainage in the treatment of pleural effusion and pneumothorax on good clinical effect, simple operation, safety, economy, high cure rate, fewer complications, can effectively reduce the patient pain, worth in clinical application. 　　【Keywords】Central venous catheter；Closed thoracic drainage；Nursing 　　胸腔积液在临床较为常见，其病因复杂，主要由于低蛋白血症、心力衰竭、急性重症胰腺炎、重症肺炎等引起［1］。中量及其以上的胸腔积液即可引起严重后果，如脱机拔管困难、呼吸困窘、心负荷加重等，若处理不及时，常常导致预后不良，住院时间被延长，甚至可危及生命[2]。目前，胸腔穿刺术是胸腔积液的传统治疗方法，而传统的胸腔闭式引流术常采用硅胶管引流，其优点是易固定，不易堵口，价格实惠，效果优良，但同时创面大，遗留疤痕，疼痛程度高[3]。而中心静脉导管胸腔闭式引流术作为一种较新的胸腔积液治疗法，局部损伤小，患者易于接受；不易引起疼痛及