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目的探讨应用中心静脉导管行胸腔闭式引流治疗新生儿气胸的临床效果。方法选择201 1年5月至2015年7月在我科应用中心静脉导管行胸腔闭式引流治疗的气胸患儿进行回顾性分析,记录患儿一般情况、可能诱因和并发疾病、气胸吸收时间、拔引流管时间、撤离呼吸机时间等。结果共纳入33例气胸患儿,肺压缩均大于30%,胸腔闭式引流手术操作时间(7.6±1.5)min,术后约0.5 h呼吸困难、发绀及三凹征明显缓解,经皮监测氧饱和度多在1面n内即升至90%以上。32例患儿经复查床旁X线胸片证实气胸在3天内完全吸收,平均(1.9±0.4)天,拔引流管时间(2.8±0.7)天,撤离呼吸机时间(2.1±0.6)天,拔管后穿刺部位皮肤创口小、愈合好,平均愈合时间(4.9±1.1)天,且均无皮肤感染,无复发,治疗后痊愈出院;1例因合并缺氧缺血性多器官损害于治疗后1天放弃治疗出院。结论应用中心静脉导管行改良胸腔闭式引流治疗新生儿气胸是一种微创、安全有效、并发症少、简捷易行的治疗技术,值得新生儿科临床推广。
Objective To investigate the clinical effect of using central venous catheter for closed thoracic drainage in the treatment of neonatal pneumothorax. Methods From May 2011 to July 2015, we retrospectively analyzed the incidence of pneumothorax in children with pneumothorax treated with venous catheter in our department from May 2015 to July 2015. The general conditions of children, possible causes and concurrent diseases, pneumothorax absorption time, Pull the drainage tube time, ventilator time and evacuation. Results A total of 33 children with pneumothorax were included in the study. The pulmonary compression was greater than 30%. The operation time of closed thoracic drainage was (7.6 ± 1.5) min. Difficulty breathing, cyanosis and triple recess sign were relieved about 0.5 h after operation. Saturation in more than one n that rose to more than 90%. Thirty-two children underwent complete radiological examination of the pneumothorax within 3 days after recheck bedside X-ray. The average duration of drainage was (2.8 ± 0.7) days and the duration of withdrawal from ventilator (2.1 ± 0.6 days) After extubation, the skin wound at the puncture site was small, healing was good, the average healing time was (4.9 ± 1.1) days, and no skin infection, no recurrence, cured and discharged after treatment; 1 case of multiple organ damage due to hypoxia and ischemia in the treatment 1 day after the abandonment of treatment and discharge. Conclusion The application of central venous catheter in the treatment of neonatal pneumothorax with modified thoracic closed drainage is a minimally invasive, safe and effective treatment with few complications and simple and easy treatment, which is worthy of clinical application in neonatology.