两种胸腔闭式引流管临床疗效剖析.docVIP

两种胸腔闭式引流管临床疗效剖析 　　[摘要] 目的 探?两种不同胸腔引流管治疗自发性气胸的临床效果及适用人群。方法 方便选取2015年1月―2016年6月收住院的104例自发性行气胸患者，随机分成2组，每52例，细管组采用8号猪尾巴管行胸腔闭式引流，粗管组则采用28号传统硅胶胸腔引流管，比较两组拔管时间、伤口愈合时间、皮下气肿发生率、堵管率、2 d肺复张率及需要治疗的疼痛发生率，并对年龄及基础肺病患者进行亚组分析，采用Logistic回归分析探索影响2 d肺复张的独立因素。 结果 总的分析显示，两组拔管时间[（5±1.5）d vs （6.0±1.2） d]、堵管率（13.5% vs 5.8%）、2 d肺复张率（76.0% vs 86.5%），差异无统计学意义（P0.05），细管组伤口愈合时间较粗管组短[（2.0±0.6 ）d vs （7.0±2.6）d]，（P0.05），而皮下气肿发生率和需要治疗的伤口疼痛发生率低于粗管组（11.5% vs 44.2%；23.1% vs 67.3%，P0.05）。Logistic回归分析显示引流管粗细、基础肺病是影响2 d肺复张的独立因素。结论 对于无基础肺病患者，采用猪尾巴管行胸腔闭式引流治疗自发性气胸安全有效，并发症低，可作为首选，但对于合并基础肺病的患者，仍建议采用传统硅胶胸腔引流管治疗。 　　[关键词] 胸腔引流；猪尾巴管；硅胶引流管；气胸 　　[中图分类号] R561 [文献标识码] A [文章编号] 1674-0742（2017）01（a）-0079-04 　　Clinical Efficacy of Two Closed Thoracic Drainage Tubes 　　ZHANG Wei-qing， HUANG Jin-long， LIN Dong-liang， XU Zhen-dong 　　Department of Thoracic Surgery， Quanzhou First Hospital Affiliated to Fujian Medical University， Quanzhou， Fujian Province， 362000 China 　　[Abstract] Objective To explore the clinical efficacy and applicable group of two different drainage tubes in the treatment of spontaneous pneumothorax. Methods Convenient selection one hundred and four inpatients with pneumothorax were randomly divided into two groups from January 2015 to June 2016. The thin tube group（n = 52） was treated by pig tail catheter， while the thick tube group was treated by traditional silica drainage tube （n =52）. The clinical outcomes including extubation time， wound healing time， rate of subcutaneous emphysema， rate of blockage pipe ， rate of lung puff of two days and the incidence of pain requiring treatment were compared between the two groups. Comparison was also conducted in the subgroups of age and underlying lung diseases. Logistic regression analysis was used to detect the independent factors of lung recruitment in two day. Results In total analysis， There was no significant difference between the two groups in the time of extubation[（5.0±1.5）d vs （6.0±1.2）d]， the rate of tube plugging（13.5% vs 5.8%） and the rate