摘要
目的探讨内科胸腔镜下自体血经外周置入中心静脉导管(PICC)瘘口注射封堵术治疗难治性气胸的临床效果。方法选取2014年6月-2018年2月宁波市第七医院诊治的90例难治性气胸患者作为研究对象,采用随机数字表法分为研究组和对照组,每组45例,研究组采用内科胸腔镜下自体血经PICC瘘口注射封堵术治疗,对照组采用常规胸腔镜手术治疗,对比2组患者的手术时间、切口长度、术中出血量、胸腔引流量、引流时间、住院时间,术前及术后第1、3、5天的疼痛程度评分(VAS)、术后1个月的肺功能、临床治疗效果。结果研究组患者的手术时间、术中出血量、胸腔引流量、引流时间、住院时间均低于对照组(均P<0.05),2组的手术切口长度差异无统计学意义(P>0.05);术前2组患者VAS评分差异无统计学意义(P>0.05);术后第1、3、5天,研究组患者的VAS评分均低于对照组(均P<0.05);术后1个月,研究组患者的第1秒用力呼气容积、用力肺活量、最大每分钟通气量、残气量与对照组比较,差异均无统计学意义(均P>0.05);术后1个月,2组患者临床疗效(研究组显效32例,有效12例,无效1例;对照组显效28例,有效14例,无效3例)比较差异无统计学意义(Z=-0.989,P>0.05)。结论内科胸腔镜下自体血PICC瘘口注射封堵术治疗难治性气胸效果肯定,创伤小,术后疼痛程度更轻。
Objective To investigate the clinical effect of occlusion with autologous blood injected through peripherally inserted central venous catheter(PICC)fistula under thoracoscope in the treatment of intractable pneumothorax.Methods Ninety patients with refractory pneumothorax treated in Ningbo Seventh Hospital between June 2014 and February 2018 were selected as the research subjects with 45 cases in each group.The study group received the autologous blood injection occlusion through PICC fistula under medical thoracoscope,while the control group received the routine thoracoscopic surgery.The operation time,incision length and intraoperative bleeding,volume of thoracic drainage,drainage time,hospitalization time,pain score(VAS)before the operation and on the 1 st,3 rd and 5 th day after the operation,pulmonary function and clinical efficacy of the two groups one month after operation were compared between the two groups.Results The operation time,intraoperative bleeding volume,thoracic drainage volume,drainage time and hospitalization time of the study group were lower than those of the control group(all P<0.05).There was no significant difference in the length of incision between the study group and the control group(P>0.05);there was no significant difference in the VAS score between the two groups before operation(P>0.05);on the 1 st,3 rd and 5 th day after the operation,the VAS score of the study group was lower than that of the control group(all P<0.05).Compared with the control group,the FEV1,FVC,MVV and RV of the study group had no significant difference(all P>0.05)one month after operation;and there was no significant difference in the clinical efficacy between the two groups one month after operation(Z=-0.989,P>0.05).Conclusion The occlusion with autologous blood injected through PICC fistula is effective for intractable pneumothorax,with fewer traumas and less pain after the operation.
作者
王镇
严东梅
戚春潮
刘海丰
郝敬铎
WANG Zhen;YAN Dong-mei;QI Chun-chao(Department of Respiratory Medicine,Ningbo Seventh Hospital,Ningbo,Zhejiang 315200,China)
出处
《中华全科医学》
2019年第12期2031-2034,共4页
Chinese Journal of General Practice
基金
浙江省医药卫生科技计划项目(2018276556)
关键词
胸腔镜
中心静脉导管
瘘口
封堵术
难治性
气胸
Thoracoscopy
Central venous catheter
Fistula
Closure
Refractory
Pneumothorax
