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目的常规胸腔闭式引流术适用于不稳定性气胸、呼吸困难明显、肺压缩程度较重、交通性或张力性气胸、反复发生气胸的患者。无论其气胸量多少,均应尽早行胸腔闭式引流。传统的肋间切开置管引流术,操作复杂且创伤大,不但易出现术中、术后出血、伤口感染、皮下气肿、引流口渗液等并发症,而且患者置管后活动受限、疼痛不适,探讨中心静脉导管胸腔穿刺引流术治疗自发性气胸的疗效和安全性。方法自2005年1月-2010年10月收治的各种病因的气胸病例采用微创中心静脉导管胸腔穿刺引流术,观察其治疗效果及不良反应。结果显效18例占60.0%,有效8例占26.6%,部分有效2例占6.7%,无效2例占6.7%,总有效率为93.3%。结论中心静脉导管胸腔置入治疗气胸简单易行,出血少,创伤小,抽气过程中可随意控制抽气速度,可反复使用,治疗彻底,值得临床推广。
Purpose Conventional closed thoracic drainage is suitable for unstable pneumothorax, dyspnea, severe pulmonary compression, traffic or tension pneumothorax, recurrent pneumothorax patients. No matter how much the amount of pneumothorax, chest drainage should be performed as soon as possible. The traditional intercostal incision catheter drainage, complicated operation and trauma, not only prone to intraoperative and postoperative bleeding, wound infection, subcutaneous emphysema, drainage port exudate and other complications, and patients with limited activity after catheterization , Pain discomfort, to explore the central venous catheter thoracic drainage for the treatment of spontaneous pneumothorax efficacy and safety. Methods From January 2005 to October 2010, patients with various causes of pneumothorax were treated with minimally invasive central venous catheter thoracentesis and drainage. The therapeutic effect and adverse reactions were observed. The results showed that 18 cases accounted for 60.0%, effective 8 cases accounted for 26.6%, partially effective in 2 cases accounted for 6.7%, ineffective in 2 cases accounted for 6.7%, the total effective rate was 93.3%. Conclusions Central venous catheterization of thoracic cavity is simple and easy to operate, with less bleeding and less trauma. The pumping speed can be controlled freely during the pumping process, which can be used repeatedly and thoroughly. It is worthy of clinical promotion.