中心静脉导管双侧引流与传统胸腔闭式引流治疗恶性胸腔积液的临床效果比较及护理要点分析

发布时间：2018-05-15 01:03

本文选题：胸腔积液 + 恶性　；参考：《临床合理用药杂志》2017年09期

【摘要】：目的比较中心静脉导管双侧引流与传统胸腔闭式引流治疗恶性胸腔积液的临床效果,并分析其护理要点。方法选取保定市第一中心医院2014年6月—2016年6月收治的恶性胸腔积液患者87例,按照随机数字表法将患者分为对照组42例与观察组45例。对照组患者给予传统胸腔闭式引流治疗,观察组患者给予中心静脉导管双侧引流治疗,两组患者均予以胸腔注射化疗药物,治疗1个月后比较两组患者呼吸困难消失时间及引流时间、一次性置管成功率、切口愈合时间、镇痛药使用率、治疗疗效、化疗药物毒副作用和置管并发症。结果观察组患者呼吸困难消失时间、引流时间、切口愈合时间短于对照组,镇痛药使用率低于对照组(P0.05);两组患者一次性置管成功率比较,差异无统计学意义(P0.05)。治疗后两组患者胸腔积液治疗效果比较,差异无统计学意义(P0.05)。两组患者化疗毒副作用发生情况比较,差异无统计学意义(P0.05)。对照组患者并发复张性肺水肿3例,严重胸膜反应2例,观察组无一例发生严重并发症。结论传统胸腔闭式引流与中心静脉导管双侧引流治疗胸腔积液的临床效果相当,但中心静脉导管双侧引流患者的引流时间、呼吸困难消失时间短,只要护理妥当,可减少堵管及移位发生,且无严重并发症,并不会增加化疗药物的毒副作用。
[Abstract]:Objective to compare the clinical effect of bilateral drainage of central venous catheter and closed drainage of traditional pleural cavity in the treatment of malignant pleural effusion and analyze its nursing points. Methods Eighty-seven patients with malignant pleural effusion from June 2014 to June 2016 in the first Central Hospital of Baoding City were selected and divided into control group (n = 42) and observation group (n = 45). The patients in the control group were treated with traditional thoracic closed drainage, the patients in the observation group were treated with bilateral drainage with central venous catheter, and the patients in both groups were treated with chemotherapeutic drugs injected into the chest. After one month of treatment, the time of disappearance of dyspnea and drainage, the success rate of one-off catheterization, the time of wound healing, the utilization rate of analgesics, the curative effect, the toxic side effects of chemotherapy drugs and complications of catheterization were compared between the two groups. Results the time of disappearance of dyspnea, drainage time and wound healing time in the observation group were shorter than those in the control group, and the utilization rate of analgesics was lower than that in the control group (P 0.05), and there was no significant difference between the two groups in the success rate of one-time catheterization. There was no significant difference in the effect of pleural effusion between the two groups after treatment (P 0.05). There was no significant difference in side effects of chemotherapy between the two groups (P 0.05). In the control group, 3 cases were complicated with retensible pulmonary edema and 2 cases with severe pleural reaction. No serious complications occurred in the observation group. Conclusion the clinical effect of traditional closed drainage of thoracic cavity is equal to that of bilateral drainage of central venous catheter in the treatment of pleural effusion, but the time of drainage and the disappearance of dyspnea in patients with bilateral drainage of central venous catheter are short, as long as nursing care is appropriate. Can reduce the occurrence of obstruction and displacement, and no serious complications, does not increase the toxicity and side effects of chemotherapeutic drugs.
【作者单位】：河北省保定市第一中心医院;
【分类号】：R473.73

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