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目的:观察比较闭式引流和常规胸腔穿刺引流辅助治疗结核性胸腔积液的疗效。方法:选择结核性渗出性胸膜炎中等量以上胸腔积液200例,随机分为闭式引流组102例与胸腔穿刺引流组98例。两组均采用同一短程化疗方案。闭式引流组采用中心静脉导管接延长管及负压引流袋,使胸腔积液自然流出,经超声检查证实积液消失后拔管;胸腔穿刺引流组采用常规穿刺方法,反复穿刺抽液,超声证实胸腔积液深度<2.0cm时停止抽液。观察两组有效率,并比较并发症发生情况、胸腔积液消失时间、住院时间及排液相关费用等情况。结果:闭式引流组总有效率86.3%,非常显著高于胸腔穿刺组的64.3%(P<0.01)。闭式引流组胸膜肥厚粘连发生率及总并发症发生率均非常显著低于胸腔穿刺组(P<0.01);闭式引流组穿刺次数、胸腔积液消失时间、平均住院时间及排液相关费用均显著或非常显著少(短)于胸腔穿刺组(P<0.05,P<0.01)。结论:闭式引流辅助治疗结核性胸腔积液疗效优于常规胸腔穿刺引流。
Objective: To compare the efficacy of closed drainage and conventional drainage of thoracic drainage in the treatment of tuberculous pleural effusion. Methods: 200 cases of pleural effusion with moderate amount of tuberculous exudative pleurisy were randomly divided into closed drainage group (n = 102) and thoracentesis drainage group (n = 98). Both groups used the same short-course chemotherapy regimen. In the closed drainage group, the central venous catheter was used to connect the extension tube and the negative pressure drainage bag to allow the effusion of the pleural effusion to flow out naturally. After effusion disappeared, the extubation was confirmed by ultrasonography. Thoracentesis and drainage were performed by puncture, Proved pleural effusion depth <2.0cm stop pumping fluid. The two groups were observed and compared the incidence of complications, disappearance of pleural effusion, hospitalization time and discharge related costs and so on. Results: The total effective rate of closed drainage group was 86.3%, which was significantly higher than 64.3% of thoracentesis group (P <0.01). The rates of pleural thickening and adhesions in closed drainage group were significantly lower than those in thoracentesis group (P <0.01). The number of punctures, the disappearance of pleural effusion, the average length of hospital stay and drainage-related costs Significant or very significantly less (short) in the thoracentesis group (P <0.05, P <0.01). Conclusion: Closed drainage of adjuvant therapy for tuberculous pleural effusion is superior to conventional thoracentesis.