中心静脉导管与常规胸腔穿刺在创伤性气胸中的临床研究

周敏杰

（渭南市澄城县医院胸外科，陕西 渭南，715200）

浏览次数：128次 下载次数：291次

摘要：

目的 观察中心静脉导管穿刺与常规胸腔穿刺治疗在创伤性气胸中的临床效果。方法 将80例创伤性气胸患者随机分为对照组和观察组，每组40例。对照组采用常规胸腔穿刺治疗，观察组采用中心静脉导管穿刺治疗。比较两组的治疗效果， 住院时间、下床活动时间、肺完全复张时间、治疗过程中引流管堵塞及止痛药物使用情况。结果 观察组治疗总有效率显著高于对照组，患者术后住院时间短于对照组，置管后每日下床活动时间长于对照组，肺完全复张时间早于对照组，且止痛药使 用比例显著低于对照组（P<0.05）。结论 采用经中心静脉导管行胸腔闭式引流治疗创伤性气胸，患者创伤小，术后恢复快，值得临床推广应用。

关键词：中心静脉导管；常规置管；创伤性气胸

中图分类号：R655文献标志码：A文章编号：2096-1413(2017)28-0053-02

Clinical research of central venous catheter and routine thoracentesis in traumatic pneumothorax
ZHOU Min-jie
(Department of Thoracic Surgery, Chengcheng County Hospital, Weinan 715200, China)

ABSTRACT: Objective To observe the clinical effect of central venous catheter and routine thoracentesis in traumatic pneumothorax. Methods Eighty cases of patients with traumatic pneumothorax were randomly divided into control group and observation group, with 40 cases in each group. The control group used routine thoracentesis treatment, while the observation group was treated with central venous catheter. The treatment effect, hospital stay, out of bed time, pulmonary complete reexpansion time, drainage tube blocking and analgesic drug use during the treatment process were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group, the postoperative hospital stay was shorter than that of the control group, the time of daily getting out of bed after taking the tube was longer than that of the control group, the pulmonary complete reexpansion time was earlier than that of the control group, and the proportion of analgesic drug use during the treatment process was significantly lower than those of the control group, the differences were statistically significant (P<0.05). Conclusion Central venous catheter has obvious effect on the traumatic pneumothorax, with minimal trauma and soon postoperative recovery, which is worthy of clinical popularization and application.
KEYWORDS: central venous catheter; routine thoracentesis; traumatic pneumothorax

参考文献：
[1] 瞿利琨.创伤性血气胸患者分别经中心静脉导管行胸腔闭式引流与常规胸腔穿刺治疗的临床效果对比研究[J].中国社区医师,2014,30(35):68-70.
[2] 熊国江,谢琰,熊汉鹏,等.微创胸腔闭式引流治疗创伤性气胸的对比研究[J].江西医药,2009,44(6):558-559.
[3] CONTOU D,RAZAZI K,KATSAHIAN S,et al.Small -bore catheter versus chest tube drainage for pneumothorax[J].Am J Emerg Med,2012,30 (8):1407-1413.
[4] 赖京玉,陈晓红,林敏芳.用中心静脉导管经皮穿刺胸腔埋管治疗气胸[J].天津医药,2001,29(10):601.
[5] WALLIN D,PRIVETTE AR,CAMBELL AR,et al.A Case of unrecognized intrathoracic placement of a subclavian central venous catheter in a patient with large traumatic hemothorax[J].Case Rep Emerg Med,2015,2015: 382624.
[6] 徐兆军,别华容,田敏,等.中心静脉导管在急救中治疗气胸72 例疗效观察[J].北华大学学报,2013,14(6):674-676.
[7] 孙海水.中心静脉导管在液气胸治疗中的应用[J].中外医疗,2011,18(20):79.
[8] AI-SAHAF M,HARLING L,HARRISON-PHIPPS K,et al.An unusual case of needle embolus presenting with delayed spontaneous pneumothorax[J].Ann Thorac Surg,2016,102(3):e201-e203.
[9] 黎芳,陈璇,张秋香,等.中心静脉导管在神经科重症监护室中的应用[J].华夏医学,2013,26(4):789-791.
[10] 冯武国.胸腔闭式引流治疗创伤性闭合性气胸56例观察[J].医学信息,2015,28(38):266-267.