便携式无痛胸腔引流管研制及治疗老年自发性气胸的研究

摘要

目的 分析便携式无痛胸腔引流管研制及治疗自发性气胸的疗效.方法 选择2015年2月-2016年3月被我院确诊并住院治疗66例自发性气胸患者进行研究.并按其治疗方案的不同分为实验组和对照组.观察组患者采用1.0-2.0%利多卡因局部浸润麻醉,采用半卧式,以胸腔镜操作孔在腋前线第3或第4肋间置管引流,且于引流处沿肋间做1.0cm-1.5cm的切口,将引流管送入胸腔,深度约6.0cm-8.0cm,观察引流情况.最后充气囊充气后,往外轻拉引流管至感觉有阻力,缝合皮肤,固定引流管,引流管接上引流袋.对照组采用1.0-2.0%利多卡因局部浸润麻醉,采用半卧式,在第2肋间为置管引流,外接水封瓶或引流袋.结果 观察组患者的疼痛程度明显小于对照组患者的疼痛程度,差异具有统计学意义(P<0.05);两组患者治疗后,肺复张所需要的时间对比发现,观察组所用的时间明显低于对照组所需要的时间,两组差异具有统计学意义(P<0.05).术后3-5天,观察组的自发性气胸恢复总有效率(87.88%)明显高于对照组的自发性气胸恢复总有效率(63.64%),差异具有统计学意义(χ2=1.819,P=0.0094).结论 便携式无痛胸腔引流管治疗自发性气胸是可行的,取得的疗效要明显优于传统胸腔闭式引流管治疗自发性气胸的疗效,值得患者采纳.%Objective To analyze the curative effect of portable painless thoracic drainage tube in treatment of spontaneous pneumothorax. Methods 132 patients with spontaneous pneumothorax were selected for study from February 2015 to March 2016 in our hospital. According to the different treatment plan, they were divided into the observation group and the control group. The observation group were treated with 1. 0% -2. 0% lidocaine local infil-tration anesthesia, and the catheter drainage was done between the third or forth intercostal anterior axillary lines by semi horizontal under thoracoscopy, and 1. 0cm-1. 5cm incision was done at drainage site along intercostal to put drainage tube into chest, at a depth of about 6. 0cm-8. 0cm. The circumstance of drainage was observed. Finally, after the inflation bag was inflated, the drainage tube was pulled out to feel the resistance, and the skin was stitched, and the drainage tube was fixed, and the drainage bag was connected with the drainage tube. The control group was given 1. 0-2. 0% lidocaine local infiltration anesthesia with semi horizontal. Catheter drainage was done at the sec-ond intercostal space, and the external water seal bottle or drainage bag was connected. Results The pain degree of the observation group was significantly less than that of the control group (P<0. 05). The time required for pulmona-ry rehabilitation was significantly shorter in the observation group than in the control group ( P<0. 05 ) . 3-5 days after operation, the total efficiency of spontaneous pneumothorax convalescent was 87. 88% in the observation group, which was significantly higher than that of the control group (63. 64%) (χ2 =1. 819, P=0. 0094). Conclusion Portable painless thoracic drainage tube has better curative effect than the traditional thoracic closed drainage tube dose in treatment of spontaneous pneumothorax, which is worth to be adopted.