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目的探讨应用猪尾式单腔中心静脉导管闭式引流及双腔气囊导尿管行胸腔闭式引流术治疗肺大泡自发性气胸的临床疗效。方法选择本院胸外科2013年12月—2014年6月收治的96例自发性气胸患者,随机将其分为对照组、猪尾单腔组、双腔气囊组各32例。按不同方法行胸腔闭式引流治疗,比较三组患者的临床疗效及手术相关情况。计量资料比较采用方差分析,两两比较采用LSD法,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 A组总有效率为46.88%(15/32),B组为90.63%(29/32),C组为100.00%(32/32),三组患者总有效率比较,差异有统计学意义(χ2=21.657,P<0.05),两两比较发现,与A组患者的有效率比较,B、C组的有效率均较高,差异均有统计学意义(均P<0.05)。三组患者住院天数比较,差异无统计学意义(P>0.05);三组患者的初次肺复张时间、伤口愈合时间、VAS评分及引流管停留时间比较,差异均有统计学意义(F=6.352、5.861、6.523、5.367,均P<0.05)。A并发症的发生率为96.9%(31/32),B组的为34.4%(11/32),C组为3.1%(1/32),三组并发症发生率比较,差异有统计学意义(χ2=8.174,P<0.05)。结论应用改良的猪尾式单腔中心静脉导管闭式引流及双腔气囊导尿管行胸腔闭式引流两种不同引流术对治疗肺大泡自发性气胸均有显著的临床疗效,但应用双腔气囊导尿管行胸腔闭式引流术更具有取材便利、引流创伤小、术后并发症少等优势,临床患者更较易接受,值得优先推广及应用。
Objective To investigate the curative effect of closed drainage of pig tail with single-lumen central venous catheter and double-lumen balloon catheter in treatment of spontaneous pneumothorax of pulmonary bulla by closed thoracic drainage. Methods A total of 96 patients with spontaneous pneumothorax admitted from December 2013 to June 2014 in our thoracic surgery were randomly divided into control group, pig tail single cavity group and double-chamber balloon group. According to different methods of closed thoracic drainage treatment, the clinical efficacy of three groups of patients and surgery-related conditions. Measurement data were compared using analysis of variance, pairwise comparison using LSD method, counting data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate was 46.88% (15/32) in group A, 90.63% (29/32) in group B and 100.00% (32/32) in group C. The total effective rate was statistically significant (χ2 = 21.657, P <0.05). The comparisons between two groups showed that the effective rates of group B and C were higher than those of group A (all P <0.05). There was no significant difference in hospitalization days between the three groups (P> 0.05). There were significant differences in the time of primary pulmonary recanalization, wound healing, VAS score and drainage tube stay between the three groups (F = 6.352,5.861,6.523,5.367, all P <0.05). The incidence of complications was 96.9% (31/32) in group A, 34.4% (11/32) in group B, and 3.1% (1/32) in group C. The complication rates of the three groups were statistically different Significance (χ2 = 8.174, P <0.05). Conclusions The application of modified pigtail single-lumen central venous catheter with closed drainage and double-lumen balloon catheter with thoracic closed drainage for the treatment of spontaneous pneumothorax have significant clinical curative effect, but the application of double-lumen Airway balloon catheter thoracic drainage more convenient access, drainage trauma, less postoperative complications and other advantages, clinical patients are more acceptable, it is worth giving priority to the promotion and application.