天津医药 ›› 2023, Vol. 51 ›› Issue (2): 213-215.doi: 10.11958/20221150

• 临床研究 • 上一篇    下一篇

胸腔延期置管引流治疗钝性创伤性中等量血胸的临床价值

李树满(), 李建国, 刘立志, 李岩欣, 李权   

  1. 天津市北辰医院外科(邮编300400)
  • 收稿日期:2022-07-21 修回日期:2022-08-05 出版日期:2023-02-15 发布日期:2023-02-24
  • 作者简介:李树满(1966),男,副主任医师,主要从事胸部外科方面研究。E-mail:15620996916@163.com
  • 基金资助:
    天津市北辰区科技计划项目(SHGY-2020013)

Clinical value of delayed thoracic drainage in the treatment of blunt traumatic medium volume hemothorax

LI Shuman(), LI Jianguo, LIU Lizhi, LI Yanxin, LI Quan   

  1. Department of Surgery, Tianjin Beichen Hospital, Tianjin 300400, China
  • Received:2022-07-21 Revised:2022-08-05 Published:2023-02-15 Online:2023-02-24

摘要:

目的 探究采用胸腔延期置管引流治疗钝性创伤性中等量血胸的治疗和预后效果。方法 选取42例钝性创伤性中等量血胸患者为延期组,先进行临床观察,确诊后72 h进行置管治疗;另43例该病患者为对照组,在确诊后24 h内即行传统早期置管治疗。比较2组的性别、年龄、体质量指数、入院胸腔积血量、肋骨骨折数、血红蛋白(Hb)、收缩压、平均动脉压、心率、受伤至入院时间;最终胸腔引流量、出院血氧饱和度(SpO2)、Hb下降水平、带管天数、住院天数、住院总费用、是否出现胸腔感染或肺不张、是否中转手术。结果 2组间基本情况的差异均无统计学意义。与对照组相比,延期组最终胸腔引流量和Hb下降水平、带管天数、住院天数和住院总费用均降低,出院SpO2升高(P<0.01)。延期组未出现胸腔感染和肺不张。2组均未出现需要中转手术的情况。结论 胸腔延期置管引流可有效改善钝性创伤性中等量血胸患者的治疗和预后效果,并可减轻患者的医疗经济负担。

关键词: 创伤,非贯通性, 血胸, 导管,留置, 钝性胸部创伤, 置管时机, 胸腔引流

Abstract:

Objective To explore the therapeutic and prognosis effects of delayed thoracic drainage in the treatment of medium volume hemothorax caused by blunt trauma. Methods Forty-two patients with medium volumn of blunt trauma hemothorax were selected as the delayed group. Clinical observation was carried out first, and catheterization was performed 72 hours after diagnosis. Another 43 patients with blunt trauma medium hemothorax were treated with traditional early catheterization within 24 hours after diagnosis, and they were used as the control group. Data of gender, age, body mass index, chest volume on admission, number of rib fractures, hemoglobin (Hb), systolic blood pressure, mean arterial pressure, heart rate and the interval from injury to admission were compared between the two groups. Data of final thoracic drainage volume, oxygen saturation (SpO2) at discharge, decline level of Hb, number of days with tube, length of hospital stay, total hospitalization cost, presence of thoracic infection and atelectasis, and converted to surgery were also compared between the two groups. Results There were no significant differences in basic conditions between the two groups. Compared with the control group, the final thoracic drainage volume and Hb decreased, the days with tube, the days of hospitalization and the total hospitalization cost decreased, and SpO2 increased after hospital discharge in the delayed group (P<0.01). No chest infection or atelectasis occurred in the delayed group. There were no cases requiring transfer to surgery in the two groups. Conclusion Delayed thoracic drainage can effectively improve the treatment and prognosis of patients with blunt traumatic medium volumn hemothorax, and reduce the medical economic burden.

Key words: wounds, nonpenetrating, hemothorax, catheters, indwelling, blunt thoracic trauma, catheterization period, thoracic drainage

中图分类号: