中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2015年
1期
51-53
,共3页
尘肺%胸腔积液%导管插入术,中心静脉
塵肺%胸腔積液%導管插入術,中心靜脈
진폐%흉강적액%도관삽입술,중심정맥
Pneumoconiosis%Pleural effusion%Catheterization,central venous
目的 观察中心静脉导管治疗顽固性胸腔积液和气胸的疗效.方法 煤工尘肺结核并发胸腔积液或气胸病例随机分为中心静脉导管组(经外周中心静脉导管置入胸腔引流)48例和常规穿刺组(常规胸腔穿刺)56例,全程督导化疗方案(DOTS),两组均应用3HRZE/6HR(H异烟肼,R利福平,Z吡嗪酰胺,E乙胺丁醇)治疗方案.结果 中心静脉导管组48例胸腔内置管]次,无脱落现象,平均抽水总量(3932±4430) ml,胸腔积液、积气消失时间为(10±2)d;40例治愈,治愈率83.33％(40/48).常规穿刺组抽水量(2753±315) ml,胸腔积液、积气消失时间(18±6)d,其中4例胸穿2次,38例胸穿3～4次,10例胸穿5次以上,平均为3.8次.26例治愈,治愈率46.43％(26/56).中心静脉导管组治愈率明显高于常规穿刺组,差异有统计学意义(x2=7.59,P＜0.01.结论 经外周中心静脉导管置入胸腔治疗胸腔积液和气胸代替胸腔闭式引流、胸腔穿刺,其临床效果好,痛苦小,方法简便.
目的 觀察中心靜脈導管治療頑固性胸腔積液和氣胸的療效.方法 煤工塵肺結覈併髮胸腔積液或氣胸病例隨機分為中心靜脈導管組(經外週中心靜脈導管置入胸腔引流)48例和常規穿刺組(常規胸腔穿刺)56例,全程督導化療方案(DOTS),兩組均應用3HRZE/6HR(H異煙肼,R利福平,Z吡嗪酰胺,E乙胺丁醇)治療方案.結果 中心靜脈導管組48例胸腔內置管]次,無脫落現象,平均抽水總量(3932±4430) ml,胸腔積液、積氣消失時間為(10±2)d;40例治愈,治愈率83.33％(40/48).常規穿刺組抽水量(2753±315) ml,胸腔積液、積氣消失時間(18±6)d,其中4例胸穿2次,38例胸穿3～4次,10例胸穿5次以上,平均為3.8次.26例治愈,治愈率46.43％(26/56).中心靜脈導管組治愈率明顯高于常規穿刺組,差異有統計學意義(x2=7.59,P＜0.01.結論 經外週中心靜脈導管置入胸腔治療胸腔積液和氣胸代替胸腔閉式引流、胸腔穿刺,其臨床效果好,痛苦小,方法簡便.
목적 관찰중심정맥도관치료완고성흉강적액화기흉적료효.방법 매공진폐결핵병발흉강적액혹기흉병례수궤분위중심정맥도관조(경외주중심정맥도관치입흉강인류)48례화상규천자조(상규흉강천자)56례,전정독도화료방안(DOTS),량조균응용3HRZE/6HR(H이연정,R리복평,Z필진선알,E을알정순)치료방안.결과 중심정맥도관조48례흉강내치관]차,무탈락현상,평균추수총량(3932±4430) ml,흉강적액、적기소실시간위(10±2)d;40례치유,치유솔83.33％(40/48).상규천자조추수량(2753±315) ml,흉강적액、적기소실시간(18±6)d,기중4례흉천2차,38례흉천3～4차,10례흉천5차이상,평균위3.8차.26례치유,치유솔46.43％(26/56).중심정맥도관조치유솔명현고우상규천자조,차이유통계학의의(x2=7.59,P＜0.01.결론 경외주중심정맥도관치입흉강치료흉강적액화기흉대체흉강폐식인류、흉강천자,기림상효과호,통고소,방법간편.
Objective To observe the clinical effect of central venous catheter in the treatment of refractory pleural effusion and pneumothorax.Methods Patients with coal workers' pneumoconiosis-tuberculosis complicated by pleural effusion or pneumothorax were randomly divided into central venous catheter group (48 cases,treated by chest drainage using a peripherally inserted central catheter) and conventional puncture group (56 cases,treated by conventional pleural puncture).Chemotherapy (DOTS strategy) was fully supervised,and both groups used 3HRZE/6HR (H,isoniazid; R,rifampicin; Z,pyrazinamide; E,ethambutol).Results In the central venous catheter group,catheterization in the thoracic cavity was performed once in all cases,without fall-off; the mean total volume of pumped effusion was 3932±4430 ml; the time to disappearance of pleural effusion and pneumatosis was 10±2 d; 40 (83.33％) of the 48 cases were cured.In the conventional puncture group,the volume of pumped effusion was 2753±315 ml; the time to disappearance of pleural effusion and pneumatosis was 18±6 d; pleural puncture was performed twice in 4 cases,3-4 times in 38 cases,and over 5 times in 10 cases,with an average of 3.8 times; 26 (46.43％) of the 56 cases were cured.The cure rate was significantly higher in the central venous catheter group than in the conventional puncture group (x2=7.59,P＜0.01).Conclusion For pleural effusion and pneumothorax,PICC can be used instead of closed thoracic drainage and pleural puncture,and it has good clinical effect,causes little pain,and is easy to operate.
