吴宪 薛新宇 乔晓雪

[摘要]目的 分析急诊常用的四种胸腔闭式引流术治疗自发性气胸的效果。方法 收集2016年8月～2017年8月我院收治自发性气胸患者80例，按照治疗方法的不同分为经典胸腔闭式切开引流术组、带细管的穿刺针穿刺置管术组、微创胸腔置管引流术组和微创胸腔置管接负压引流术组四组，每组各20例。分别予以经典胸腔闭式切开引流术、带细管的穿刺针穿刺置管术、微创胸腔置管引流术和微创胸腔置管接负压引流术进行临床治疗，分析不同组别治疗总有效率、治疗时间和并发症（伤口疼痛、皮下气肿）发生率。结果 四组的总有效率、治疗时间比较，差异均无统计学意义（P>0.05）；其中，微创胸腔置管接负压引流术组的治疗时间为（3.51±1.13）d，短于其他三组（P<0.05），微创胸腔置管接负压引流术组并发症发生率（0.00%），低于其他三组，差异有统计学意义（P<0.05）。结论 微创胸腔置管接负压引流术治疗自发性气胸的临床价值更为显著，具有手术操作简单，无并发症的临床应用优势性。

[关键词]急诊；胸腔闭式引流术；自发性气胸；效果分析

[中图分类号] R615 [文献标识码] A [文章编号] 1674-4721（2018）7（c）-0061-03

[Abstract]Objective To analyze the efficacy of four common thoracic closed drainages for emergency treatment of spontaneous pneumothorax. Methods A total of 80 patients with spontaneous pneumothorax in our hospital were enrolled from August 2016 to August 2017. They were divided according to different treatment method. They were treated with thoracic closed drainage，puncture catheterization with fine tube， minimal invasion of thoracic catheter drainage， and minimal invasion of thoracic catheter connecting with negative pressure drainage in the clinic， 20 cases in each group. The total therapeutic effectiveness rate， treatment time， and incidence of complications such as wound pain， and subcutaneous emphysema were analyzed in different groups. Results There was no significant difference in the total effectiveness rate or treatment time among the four groups （P>0.05）. Among them， the treatment time and incidence of complications in group of minimal invasion of thoracic catheter connecting with negative pressure drainage were （3.51±1.13） d and 0.00%， which were much lower than those in the other three groups with statistical difference （P<0.05）. Conclusion The clinical value of minimal invasion of thoracic catheter connecting with negative pressure drainage is remarkable for the treatment of spontaneous pneumothorax at advantages of simple operation and no complications occurred in clinical applicaiton.

[Key words] Emergency； Thoracic closed drainage； Spontaneous pneumothorax； Curative effect analysis

原发性气胸在青年人中常易发生，是指经胸部影像学检查未发现病变的健康者发生的气胸，一般而言，瘦高男性者发生原发性气胸的概率更高。在传统的治疗方式中，大多应用橡胶管进行临床治疗，该种治疗方式具有一定缺点，如治疗过程复杂且创伤大；胸腔闭式切开引流术、带细管穿刺针穿刺置管术、微创胸腔置管引流术、微创胸腔置管接负压引流术均是目前临床常用治疗自发性气胸的方式[1]，本文主要分析急诊常用的四种胸腔闭式引流术治疗自发性气胸的效果，现报道如下。

1资料与方法

1.1一般……