胸腔内灌注自体血联合粗管负压吸引治疗难治性气胸的临床研究
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摘要
目的:观察胸腔内灌注自体血联合粗管负压吸引治疗难治性气胸的有效性及安全性。方法:回顾分析62例难治性气胸的患者,研究组30例胸腔内灌注自体血联合粗管持续负压吸引患者;对照组32例为单纯粗管持续负压吸引的患者。结果:研究组平均漏气时间为4.6d,对照组为11.2d;研究组胸管拔除时间平均为6.2d,对照组为13.3d;研究组治疗后住院时间平均为8.4d,对照组为16.8d;治疗后观察1个月研究组总有效率为91%,对照组为75%;两组对比差异有统计学意义(P值均<0.05)。治疗后研究组胸痛2例(6.7%),对照组为1例(3.1%);研究组发热1例(3.3%),对照组为1例(3.1%);两组对比差异无统计学意义(P>0.05)。随访2年,研究组复发2例,总复发率6.7%;对照组复发10例,总复发率31.3%;两组复发率对比差异有统计学意义(P<0.05)。结论:胸腔内灌注自体血联合粗管负压吸引治疗难治性气胸疗效肯定,不良反应少,复发率低。
Objective:To evaluation of the efficacy and safety of autologous blood pleurodesis under vacuum aspiration in treatment of intractable pneumothorax.Methods:62 patients with intractable pneumothorax were given closed thoracic drainage and continuous negative pressure drainage suction.The patients in the treatment group were injected autologous blood into the pleura cavity under vacuum suctions,and the patients in the control group were under vacuum suctions.Results:The average leakage time of the study group was 4.6 days and the control group was 11.2 days.The average extubation time was 6.2 days in the study group and 13.3 days in the control group.The average hospital stay time was 8.4 days in the study group and 16.8 days in the control group.A month later after treatment,total effective rate of the study group was 91%,control group was 75%.There was statistical significance between the two groups(P<0.05).There were 2 patients(6.7%)with light chest pain,1 patient(3.3%)with fever in the study group.There were 1 patient(3.1%)with light chest pain and 1 patient(3.1%)with fever in the control group.There was statistical significance between the two groups(P<0.05).In 2-year follow-up study,2 patients(6.7%)recurred in the treatment group and 10 patients(31.3%)recurred in the control group.There was statistical significance between the recurrence rate of the two groups(P<0.05).Conclusion:Autologous blood pleurodesis assisted with vacuum aspiration for intractable pneumothorax has sure therapeutic effect,few adverse reaction and low recurrence rate.
Objective:To evaluation of the efficacy and safety of autologous blood pleurodesis under vacuum aspiration in treatment of intractable pneumothorax.Methods:62 patients with intractable pneumothorax were given closed thoracic drainage and continuous negative pressure drainage suction.The patients in the treatment group were injected autologous blood into the pleura cavity under vacuum suctions,and the patients in the control group were under vacuum suctions.Results:The average leakage time of the study group was 4.6 days and the control group was 11.2 days.The average extubation time was 6.2 days in the study group and 13.3 days in the control group.The average hospital stay time was 8.4 days in the study group and 16.8 days in the control group.A month later after treatment,total effective rate of the study group was 91%,control group was 75%.There was statistical significance between the two groups(P<0.05).There were 2 patients(6.7%)with light chest pain,1 patient(3.3%)with fever in the study group.There were 1 patient(3.1%)with light chest pain and 1 patient(3.1%)with fever in the control group.There was statistical significance between the two groups(P<0.05).In 2-year follow-up study,2 patients(6.7%)recurred in the treatment group and 10 patients(31.3%)recurred in the control group.There was statistical significance between the recurrence rate of the two groups(P<0.05).Conclusion:Autologous blood pleurodesis assisted with vacuum aspiration for intractable pneumothorax has sure therapeutic effect,few adverse reaction and low recurrence rate.
引文
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[9]祝纯礼,万雄,桂天绪,等.内科胸腔镜下自体血补丁治疗难治性气胸的临床价值[J].微创医学,2010,5(3):233-234.
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[2]陈全德.红霉素胸膜固定术治疗难治性气胸的研究[J].中国医学工程,2011,19(1):81-83.
[3]钟敏华,厉银平,谢志斌,等.胸腔镜介入治疗难治性气胸32例的临床观察[J].内科急危重症杂志,2010,16(4):193-195.
[4]彭清臻,谢志斌,余小明,等.内科胸腔镜介入治疗难治性自发性气胸32例临床探讨[J].临床肺科杂志,2011,16(2):176-178.
[5]张朴,余小倩,高云,等.生物蛋白胶在胸腔镜下治疗难治性气胸中的应用[J].临床肺科杂志,2005,10(1):38-39.
[6]王学忠,李军,刘天华.经纤维支气管镜介入治疗难治性气胸10例[J].疑难病杂志,2008,7(2):111-113.
[7]董文,黄奕江,吴海洪,等.内科胸腔镜治疗难治性气胸的疗效分析并文献复习[J].中国内镜杂志,2010,16(11):177-183.
[8]徐元峰,阚积香.负压吸引下自体血胸腔粘连术治疗难治性气胸临床研究[J].临床肺科杂志,2006,11(6):713-714.
[9]祝纯礼,万雄,桂天绪,等.内科胸腔镜下自体血补丁治疗难治性气胸的临床价值[J].微创医学,2010,5(3):233-234.
[10]魏娇,刘乾中.红霉素胸膜固定术治疗难治性气胸的探讨[J].实用临床医学,2009,10(9):30-32.