应用导管型压阀式胸腔穿刺针胸腔闭式负压引流胸腔积液的方法.DOC

应用导管型压阀式胸腔穿刺针胸腔闭式负压引流治疗 胸腔积液的方法 李胜利 王艳芹 李秀叶 孔令海 赵毅峰 王保利 河北省邯郸市第四医院 河北 邯郸 056200 【摘要】 目的 探讨采用自行研制的导管型压阀式胸腔穿刺针通过胸腔闭式负压引流治疗胸腔积液的临床效果。方法 应用自行设计的导管型压阀式胸腔穿刺针行胸腔闭式负压引流胸腔积液45例，男26例，女19例，年龄8~76岁，平均54.2岁。其中结核性13例，肿瘤性21例，肺炎支原体肺炎合并胸腔积液5例，脓胸4例，其他原因2例。结果 共置管53例次，均一次穿刺、置管成功，保留时间3~13天。3例患者于置管4天后出现引流不畅或堵管，经盐水或尿激酶冲管后完成引流；1例患者出现脱管现象，重新置管后正常引流。未出现复张性肺水肿、液气胸或感染等穿刺相关并发症。结论 应用导管型压阀式胸腔穿刺针行胸腔闭式负压引流治疗胸腔积液具有操作简便，安全可靠，引流效果确切，实用性强等特点，提高了患者耐受性和依从性，值得临床推广应用。 【关键词】穿刺针；导管插入术；引流术；胸腔积液 Application of the method using catheter-with valve thoracentesis needle to drain pleural effusion through a negative-pressured close-loop system LI Shengli WANG Yanqin LI Xiuye KONG Linghai ZHAO Yifeng WANG Baoli The Fourth Hospital of Handdan, Hebei 056200, Chain 【Abstract 】 Objective To investigate the treatment effectiveness of draining pleural effusion from pleural space through a negative pressure maintained close-loop drainage system using self-developed catheter-with-valve thoracentesis needle. Method The self- developed catheter-with-valve thoracentesis needle was used to treat patients by draining the pleural effusion from pleural space through a close-loop drainage system in which negative pressure was maintained. A total of 45 patients were treated with this method, including 26 male patients and 19 females at the age of 8-76 with the average age of 54.2. ?Among these patients, there were 13 cases of?tuberculosis, 21 cases of cancer, 5 cases of mycoplasma pneumoniae pneumonia combined with pleural effusion, 4 cases of?empyema?and two cases resulting from other reasons. ?Results Thoracentesis and catheter installation were performed successfully 53 times and the retention time of the indwelling catheter? was in the range of 3-13 days. There were 3 cases with poor drainage or blocking appearing 4 days after catheter installation, for which the drainage was fully completed after catheter flushing with salt water or urokinase. There was one patient with the case of catheter disconnection, for whom