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目的评价中心静脉导管微创闭式引流治疗结核性胸腔积液的应用价值。方法将住院的68例结核性胸腔积液患者随机分为引流组33例和胸穿组35例,所有病例按常规抗结核治疗。引流组采用中心静脉导管引流胸腔积液,定时开关导管;胸穿组常规胸腔穿刺,每周抽液1～3次。结果引流组患者胸水排净时间〔(3.40±1.05)vs(13.20±4.03)d〕、住院时间〔(8.60±4.28)vs(23.20±5.36)d〕、穿刺次数〔(1.20±0.44)vs(5.80±2.11)次〕等均少于胸穿组(P均<0.01)。引流组治愈率高于对照组(90.9%vs65.7%,P<0.05)。引流组发生导管堵塞或引流不畅4例,无其他并发症发生;胸穿组胸膜反应1例,气胸2例,胸膜增厚4例。结论中心静脉导管引流治疗结核性胸腔积液,安全简便,创伤小,疗效优于常规胸腔穿刺术。
Objective To evaluate the value of central venous catheter minimally invasive closed drainage in the treatment of tuberculous pleural effusion. Methods A total of 68 hospitalized patients with tuberculous pleural effusion were randomly divided into drainage group (33 cases) and thoracentesis group (35 cases). All cases were treated with conventional anti-TB therapy. The drainage group used the central venous catheter to drain pleural effusion and switch the catheter regularly. The thoracentesis group performed routine thoracentesis once or three times per week. Results The drainage time of pleural effusion in the drainage group was (3.40 ± 1.05) vs (13.20 ± 4.03) d, the length of hospital stay was (8.60 ± 4.28) vs (23.20 ± 5.36) d, the number of puncturing was (1.20 ± 0.44) vs 5.80 ± 2.11) times, etc. were less than the chest wear group (P <0.01). The cure rate of drainage group was higher than that of control group (90.9% vs65.7%, P <0.05). There were 4 cases of catheter blockage or poor drainage in the drainage group, no other complications occurred; 1 case of pleural reaction, 2 cases of pneumothorax and 4 cases of pleural thickening. Conclusion Central venous catheter drainage for the treatment of tuberculous pleural effusion, safe and simple, less trauma, the effect is superior to conventional thoracentesis.