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目的探讨应用新型胸腔引流管行胸腔闭式引流术治疗新生儿气胸的临床疗效。方法选择2012年1月至2015年9月本院新生儿病房行胸腔闭式引流术治疗的新生儿气胸患儿为研究对象,因不同住院时期治疗方法不同分为老式硅胶管组、静脉留置针组和新型胸腔引流管组。比较3组患儿一般情况、置管所需时间、引流时间、机械通气时间及各种并发症发生率。结果共纳入新生儿气胸患儿54例,其中老式硅胶管组19例,静脉留置针组11例,新型胸腔引流组24例,各组患儿性别、胎龄、出生体重及肺压缩比例比较差异均无统计学意义(P>0.05)。新型胸腔引流管组置管时间短于老式硅胶管组[(1.6±0.8)h比(2.5±1.1)h];引流时间和机械通气时间短于静脉留置针组[(1.9±0.5)d比(2.9±0.4)d,(2.8±2.1)d比(4.9±2.1)d],有效率高于静脉留置针组(95.8%比63.6%),感染率低于老式硅胶管组(8.3%比42.1%),堵管率低于静脉留置针组(16.7%比54.5%),差异均有统计学意义(P<0.05)。各组脱管率差异无统计学意义(P>0.05)。结论应用新型胸腔引流管行胸腔闭式引流术治疗新生儿气胸效果好、损伤小、安全有效,建议在临床推广使用。
Objective To investigate the clinical effect of using new chest drainage tube in the treatment of neonatal pneumothorax by closed thoracic drainage. Methods From January 2012 to September 2015, neonatal pneumothorax was treated in neonatal ward of our hospital undergoing closed thoracic drainage. The patients were divided into three groups: old silicone tube group, intravenous indwelling needle group Group and a new chest drainage tube group. The general situation of children in the three groups were compared, the time required for catheterization, the drainage time, the time of mechanical ventilation and the incidence of various complications. Results A total of 54 neonates with pneumothorax were enrolled in this study. Among them, 19 were old silicone tube group, 11 were intravenous catheterization group and 24 were new pleural drainage group. There were significant differences in sex, gestational age, birth weight and lung compression ratio No statistical significance (P> 0.05). The catheterization time was shorter in the new type of thoracic drainage tube than in the old silicone tube group [(1.6 ± 0.8) h vs (2.5 ± 1.1) h]; the drainage time and mechanical ventilation time were shorter than those in the indwelling needle group [(1.9 ± 0.5) d (2.9 ± 0.4) d, (2.8 ± 2.1) d vs (4.9 ± 2.1) d], and the effective rate was higher than that of the intravenous catheter group (95.8% vs 63.6%). The infection rate was lower than that of the old silicone tube group 42.1%), and the rate of occlusion was lower than that of intravenous injection (16.7% vs 54.5%). The difference was statistically significant (P <0.05). There was no significant difference in the rate of drug withdrawal between the two groups (P> 0.05). Conclusion The application of the new thoracic drainage tube thoracic drainage for the treatment of neonatal pneumothorax effect, less damage, safe and effective, it is recommended for clinical use.