微创置管治疗慢性阻塞性肺疾病并发自发性气胸患者的临床疗效

摘要

目的：探讨微创置管治疗慢性阻塞性肺疾病（ COPD）并发自发性气胸患者的临床疗效。方法选择2010年9月—2013年9月福建医科大学附属泉州第一医院收治的COPD并发自发性气胸患者42例，根据置管方法不同分为：对照组22例，应用常规胸腔闭式引流术治疗；研究组20例，应用微创置管方法治疗。记录两组患者的平均操作时间、置管时间、肺复张时间、伤口愈合时间及疼痛视觉模拟评分（ VAS），比较两组患者的临床疗效及并发症发生率。结果研究组较对照组平均操作时间、置管时间、肺复张时间、伤口愈合时间缩短，VAS降低（P<0.05）。对照组治愈10例、有效8例、无效4例，研究组治愈10例、有效9例、无效1例，两组临床疗效比较，差异无统计学意义（u=2.561，P=0.382）。研究组堵管率、皮下气肿发生率、伤口感染发生率及胸膜反应发生率较对照组均减少（P<0.05）。结论应用微创置管治疗COPD合并自发性气胸患者的操作时间、置管时间、肺复张时间、伤口愈合时间缩短，生活质量提高，临床疗效显著，且各种并发症发生率降低，值得临床推广。%Objective To analyze the clinical efficacy of minimally invasive catheter in the treatment of chronic ob-structive pulmonary disease( COPD)combined with spontaneous pneumothorax. Methods 42 COPD patients combined with spontaneous pneumothorax admitted to Quanzhou First Hospital Affiliated of Fujian Medical University from September 2010 to September 2013 were divided into control group and study group. The 22 cases in the control group were given the application of conventional closed thoracic drainage treatment,and the 20 cases in the study group were given the application of minimally inva-sive catheter treatment. The average operation time,indwelling catheter time,pulmonary reexpansion time,healing time and pain visual analogue scale( VAS)of the two groups were recorded,and the clinical efficacy and incidence of complication were compared between the two groups. Results Compared with the control group,the study group had shorter average operation time,indwelling catheter time,pulmonary reexpansion time,wound healing time and lower VAS(P<0. 05). In the control group,10 cases were cured,8 cases were effective and 4 cases were invalid,while in the study group,10 cases were cured,9 cases were effective and 1 case was invalid. The difference between the two groups was not statistically significant(u=2. 561,P=0. 382). Compared with the control group,the plugging rate,incidence of subcutaneous emphysema,incidence of wound in-fection and incidence of pleural reaction were decreased in the study group(P<0. 05). Conclusion The application of mini-mally invasive catheter method in treatment of COPD combined with spontaneous pneumothorax can shorten the average operation time,indwelling catheter time,pulmonary reexpansion time,wound healing time,and can improve life quality and clinical effi-cacy as well as reduce incidence of complication,and thus it should be promoted in clinic.