中心静脉导管在胸腔积液和气胸中应用体会.docVIP

中心静脉导管在胸腔积液和气胸中应用体会 【摘要】目的：观察中心静脉导管留置胸腔闭式引流术 治疗各种胸腔积液和气胸的临床疗效和安全性。方法：用单 腔中心静脉导管，长约30 cm硅胶引流管、引流瓶组成密闭 的引流系统，对65例自发性气胸和76例中等量以上胸腔积 液，包括外伤性血气胸或自发性液气胸37例、胸腔积液或 恶性肿瘤伴胸腔积液39例，共计141例患者进行中心静脉 导管闭式引流术。结果：胸腔积液有效率为94%; 65例气胸 除2例行切开闭式引流外，其余均治愈，有效率95%。结论: 用单腔中心静脉导管、引流管、引流瓶组成的胸腔闭式引流 是一种简便、有效、安全、可靠、患者容易接受的治疗胸腔 积液和气胸的引流方法。 【关键词】中心静脉导管；胸腔闭式引流术；胸腔 积液；气胸 [Abstract] Objective： To observe the clinical therapeutic effects and safety of central venous catheter in the treatment of pleural effusion and pneumothorax. Method： A closed drainage system by a single-lumen central venous line about 30 centimeters silicone sterilization drainage tube and one drainage bottle composition. A total of 141 patients were treated with central venous catheter for the closed drainage of thoracic cavity. It s included 65 spontaneous pneumothorax patients and 76 medium pleural effusion patients. In 76 cases, there were 37 patients who were traumatic hemothora and hydropneumothorax. The others 39 patients were pleural effusions or malignant pleural effusions. Result： The total effective rate was 94% in pleural effusion patients. In 65 spontaneous pneumothorax patients, there were all cured except 2 cases with open closed drainage. It’ s effective rate was 95%. Conclusion： The closed drainage system with central venous catheter, drainage tube and drainage bottle is simple, safe and effective method, to cure the pleural effusion and peumothorax， which is easy to be accepted by patients. [Key words ] Central venous catheter； Closed thoracic drainage； Pleural effusion； Pneumothorax First-author’ s address : The First People ? s Hospital of Hefei, Hefei 230061， China doi： 10.3969/j. issn.1674-4985.2014. 22. 053 随着医用材料及技术的进步，经皮胸腔微创置管闭式引 流应用日趋广泛，许多证据表明在大多数情况下，静脉导管 (F8-F14)不仅可以达到与普通硅胶管相同的引流效果，而 且更加舒适、易于置入、住院时间缩短、治疗费用明显下降 ［1］。因此，静脉导管在胸腔引流中的地位已得到公认。本 文分析了 2011年9月-2013年12月本科使用单腔中心静脉 导管留置胸腔闭式引流术治疗胸腔积液和气胸患者141例的 临床资料，总结应用该导管的临床经验和体会，现报告如下。 1资料与方法 1.1 一般资料全组141例病例中，男106例，女35例， 年龄16?89岁，平均52岁，包括76例中等量以上胸腔积 液(外伤性血气胸37例、恶性肿瘤伴