中心静脉导管胸腔置管引流在胸腔积液治疗中的应用价值.docxVIP

中心静脉导管胸腔置管引流在胸腔积液治疗中的应用价值 王博文 章革民 叶俊黄严春朱雄林王强 (武汉市新洲区人民医院内三科430400) 【摘要】目的 探讨中心静脉导管胸腔置管引流在胸腔积液治疗中的应用价 值。方法 回顾性分析168例胸腔积液患者，随机分成两组，引流组(96例) 和胸穿组(72例)，引流组采用中心静脉导管行胸腔置管引流术，胸穿组使用传 统胸腔穿刺术，两组年龄，病情差异无统计学意义(Pgt；0.05),对这两组的操 作过程，治疗效果及不良反应发牛率进行比较。结果 引流组均成功引流胸水, 胸水引流彻底，操作过程患者容易耐受，呼吸困难明显缓解，无明显不良反应发 牛。胸穿组出现病情较重者不能耐受，胸水引流不彻底，出现胸膜反应穿刺不成 功等情况。结论中心静脉导管胸腔置管引流术较传统胸腔穿刺术在胸腔积液的 治疗中更安全，有效，值得临床推广。 【关键词】胸腔积液 中心静脉导管 胸腔置管引流术 传统胸腔穿刺术 【中图分类号】R655 【文献标识码】A 【文章编号】2095-1752 (2014) 12-0078-02 [Abstract] objective :explore the central venous catheter chest tube drainage in the treatment of pleural effusion and application value. Method:a retrospective analysis of 268 patients with pleural effusion, and randomly divided into two groups, the treatment group (96 cases) and control group (72 cases), the treatment group with central venous catheter line of chest drainage tube, control group using traditional thoracentesis, two groups of age, there was no statistical significanee (P gt; 0.05) difference condition and operation method of the two groups, the treatment effect, and to compare the incidenee of adverse reactions. Result: the treatment group were successful drainage of pleural effusion, pleural effusion drainage thoroughly, patients with operation easy to tolerance, obviously alleviate illness ,Patients with more severe cases cannot tolerate, pleural effusion drainage is not thorough, appeared pleural reaction puncture is not successful, and so on and so forth. Conclusion: central venous catheter pleural drainage than traditional thoracentesis tube in the treatment of pleural effusion is safe, effective, worthy of clinical promotion. 【Key words］ Pleural effusion Central venous catheter The chest tube drainage Traditional thoracentesis 胸腔积液是常见的的临床问题，肺，胸膜和肺外疾病均可引起，结核性胸膜 炎，胸膜恶性肿瘤，心肝肾功能不全等疾病患者因胸膜腔内液体形成过快或吸收 过缓都会产生胸腔积液，中等量以上即可有压迫症状，穿刺放液可以减轻或消除 压迫症状，减轻毒血症状，改善患者的生存质量，也可为其他治疗奠定基础［1］。 传统的治疗方法是用胸腔穿刺针做胸腔穿刺抽液，往往需反复多次穿刺，操作时 间长，增加患者的痛苦和穿刺的风险及感染的机会，导致的并发症增多［2］。近 年来，我科引进中心静脉导管做胸腔置管引流用于胸腔积液的治疗，由于其创伤 小，操作时间短，并发症少