中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
36期
4364-4367
,共4页
肺疾病,慢性阻塞性%气胸%外科手术,微创性%并发症
肺疾病,慢性阻塞性%氣胸%外科手術,微創性%併髮癥
폐질병,만성조새성%기흉%외과수술,미창성%병발증
Pulmonary disease,chronic obstructive%Pneumothorax%Surgical procedures,minimally invasive%Complications
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。
目的：探討微創置管治療慢性阻塞性肺疾病（ COPD）併髮自髮性氣胸患者的臨床療效。方法選擇2010年9月—2013年9月福建醫科大學附屬泉州第一醫院收治的COPD併髮自髮性氣胸患者42例，根據置管方法不同分為：對照組22例，應用常規胸腔閉式引流術治療；研究組20例，應用微創置管方法治療。記錄兩組患者的平均操作時間、置管時間、肺複張時間、傷口愈閤時間及疼痛視覺模擬評分（ VAS），比較兩組患者的臨床療效及併髮癥髮生率。結果研究組較對照組平均操作時間、置管時間、肺複張時間、傷口愈閤時間縮短，VAS降低（P<0.05）。對照組治愈10例、有效8例、無效4例，研究組治愈10例、有效9例、無效1例，兩組臨床療效比較，差異無統計學意義（u=2.561，P=0.382）。研究組堵管率、皮下氣腫髮生率、傷口感染髮生率及胸膜反應髮生率較對照組均減少（P<0.05）。結論應用微創置管治療COPD閤併自髮性氣胸患者的操作時間、置管時間、肺複張時間、傷口愈閤時間縮短，生活質量提高，臨床療效顯著，且各種併髮癥髮生率降低，值得臨床推廣。
목적：탐토미창치관치료만성조새성폐질병（ COPD）병발자발성기흉환자적림상료효。방법선택2010년9월—2013년9월복건의과대학부속천주제일의원수치적COPD병발자발성기흉환자42례，근거치관방법불동분위：대조조22례，응용상규흉강폐식인류술치료；연구조20례，응용미창치관방법치료。기록량조환자적평균조작시간、치관시간、폐복장시간、상구유합시간급동통시각모의평분（ VAS），비교량조환자적림상료효급병발증발생솔。결과연구조교대조조평균조작시간、치관시간、폐복장시간、상구유합시간축단，VAS강저（P<0.05）。대조조치유10례、유효8례、무효4례，연구조치유10례、유효9례、무효1례，량조림상료효비교，차이무통계학의의（u=2.561，P=0.382）。연구조도관솔、피하기종발생솔、상구감염발생솔급흉막반응발생솔교대조조균감소（P<0.05）。결론응용미창치관치료COPD합병자발성기흉환자적조작시간、치관시간、폐복장시간、상구유합시간축단，생활질량제고，림상료효현저，차각충병발증발생솔강저，치득림상추엄。
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.
