中心静脉导管在急救中治疗气胸72例疗效观察

目的评价急诊急救中用中心静脉导管作胸腔闭式引流治疗气胸的临床疗效和安全性．方法收集72例急性气胸患者,随机分为两组,实验组36例用中心静脉导管作胸腔闭式引流,对照组36例用穿刺针作胸腔闭式引流,比较两组患者的临床指征、治疗效果、并发症情况．结果实验组手术时间（6．7±2．1）min、肺复张时间（3．8±1．4）d、术后住院时间（7．3±0．9）d均明显小于对照组的（10．3±2．5）lnin,（5．1±2．0）d,（11．2±1．5）d,实验组总有效率（97．2％）明显高于对照组（83．3％）,实验组皮下气肿发生率（5．6％）、疼痛发生率（11．1％）、堵管发生率（0）、创伤性血胸发生率（2．8％）均明显低于对照组的38．9％,33．3％,13．9％,30．6％,两组比较差异均具有统计学意义（P〈0．05）．结论中心静脉导管术在急救中治疗气胸是一种简便易行、安全有效、并发症少、易被患者接受的方法,在现场急救及转运过程中尤其适用,值得临床推广．

Observation on Curative Effect of Central Venous Catheter in the Emergency Treatment of 72 Cases with Pneumothorax

Objective To evaluate the clinical efficacy and safety of central venous catheter in the emergency treatment of pneumothorax with closed thoracic drainage. Method 72 patients with acute pneumothorax were randomly divided into two groups. 36 Patients in experimental group were treated with central venous catheter for the closed drainage of thoracic cavity and 36 patients in control group were treated with puncture needle for the thoracic closed drainage. The clinical indications, treatment effect and complications of patients in both groups were compared. Results Operation time （6.7 ± 2. 1 ） rain, pulmonary reexpansion time （3. 8 ± 1.4） d, postoperative hospitalization time （7.3 ± O. 9 ） d in the experimental group were significantly less than those in the control group,which were respectively （ 10.3 ± 2.5） rain, （5. 1 ± 2.0） d and （ 11.2 ± 1.5 ） d. The total efficiency rate in the experimental group （97. 2% ）was significantly higher than that in the control group （83.3%）. The incidence of subcutaneous emphysema （5. 6% ） , incidence of pain （ 11. 1% ） , incidence of plugging（0% ）and incidence of traumatic hemothorax（2.8% ） in experimental group were significantly lower than that in the control group,which were respectively 38.9% ,33.3%, 13.9%, and 30.6%. The differences of two groups were statistically significant （P 〈 0.05 ）. Conclusion The central venous catheter in the emergency treatment of pneumothorax is a simple, safe and effective method, and can induce less complications, which is easy to be accepted by patients, especially suitable to the emergency transport and treatment of patients with pneumothorax, and worthy to be popularized in clinic.