冯建国

[摘要] 目的 探討负压引流球管在外伤性血气胸引流中的效果。方法 收集105例于2016年1月—2017年12月在该院胸外科因外伤性血气胸行胸腔闭式引流的患者的临床资料，方便筛选出62例患者为研究对象，按照使用引流管的不同分为两组（16F组和26F组）。16F组共30例，使用管径16F的负压引流球管行胸腔闭式引流;26 F组共32例，使用管径26F的引流管行胸腔闭式引流，对比两组临床效果。 结果 ①两组术后均未发生引流管相关性感染。②16F组患者漏气时间（2.80±1.00）d、皮下气肿发生率30%和再置管率0%与26F组比较，差异无统计学意义（t1=1.207 3，t2=0.572 3，t3=0.582 4，P>0.05）。③16F组术后总引流量（497.00±113.63）mL少于26F组（656.25±252.01）mL（t=12.007，P<0.05），引流时间短（8.60±2.04）d于26F组（13.25±10.41）d（t=5.781 0，P<0.05），止痛药使用次数（1.30±0.65）次低于26F组（t1=14.211 8，t2=12.345 5，t3 =6.890 7，P<0.05），术后满意度86.66%和再置管接受度86.66%优于26F组（χ21=31.072，χ22 = 31.072，P<0.05）。 结论 与传统粗引流管（≥26F）相比，负压引流球管用于非手术类的外伤性血气胸的胸腔引流一样安全可靠，而且其疼痛刺激更小，堵管后易于疏通，肺无漏气后可转接负压球方便患者活动，此种引流方式更易被患者接受，有助于患者的快速康复。

[关键词] 引流管;血气胸;胸腔闭式引流;胸外伤

[中图分类号] R5          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0051-03

Experience of Application of Negative Pressure Drainage Tube in Traumatic Hemopneumothorax Drainage

FENG Jian-guo

Department of Thoracic Surgery， Tongzhou District People's Hospital， Nantong， Jiangsu Province， 226300 China

[Abstract] Objective To investigate the effect of negative pressure drainage tube in traumatic pneumothorax drainage. Methods A total of 105 patients with thoracic thoracic surgery who had undergone traumatic blood gas thoracic drainage in the hospital from January 2016 to December 2017 were selected for clinical data and 62 patients were convenient selected as study subjects， according to the use of drainage tubes， they were divided into two groups （16F group and 26F group）. A total of 30 patients in the 16F group underwent closed thoracic drainage with a negative pressure drainage tube with a 16F diameter. In the 26F group， there were 32 patients. The thoracic closed drainage was performed using a drainage tube with a diameter of 26F. The clinical efficacy was compared between the two groups. Results ①Drainage tube-related infection did not occur in both groups. ②There was no significant difference in the leakage time （2.80±1.00） d， subcutaneous emphysema incidence 30% and re-admission rate 0% between the 16F group and the 26F group （t1=1.207 3， t2=0.572 3， t3=0.582 4， P>0.05）. ③The total drainage volume （497.00±113.63）mL in the 16F group was lower than that in the 26F group （656.25±252.01） mL（t=12.007， P<0.05）， and the drainage time was short （8.60±2.04）d in the 26F group （13.25 ±10.41）d， （t =5.7810， P<0.05）. The number of analgesics used （1.30±0.65）times was lower than that of group 26F （t1=14.2118， t2=12.345 5， t3=6.890 7， P<0.05）. Satisfaction 86.66% and repercussion tube acceptance 86.66% were better than those of 26F group （χ21 =31.072， χ22=31.072， P<0.05）. Conclusion Compared with the traditional coarse drainage tube （≥26F）， negative pressure drainage tube is used for non- surgical traumatic pneumothorax thoracic drainage， safe and reliable， and its pain stimulation is smaller， easier to clear after blocking the tube， the lungs can be transferred after the negative pressure ball to facilitate patient activity， this drainage is more easily accepted by the patient， which can help patients recover quickly.

[Key words] Drainage tube; Pneumothorax; Closed thoracic drainage; Chest trauma

以负压引流球管接负压球进行负压吸引作为胸腔积液的一种治疗方式在临床中已使用多年。负压引流球管具有易挤压、防折叠、管道透明易观察等特点，接负压球后可主动引流且能预防逆行性感染，轻便易携带。但对于气胸或液气胸，多数医院仍采用传统的粗引流管（≥26F）接水封瓶的方式进行胸腔闭式引流。粗引流管对胸膜刺激大，对肋间神经易产生压迫，连接水封瓶后限制患者自主活动，一定程度上影响患者的肺功能锻练和恢复。该次研究以该院2016年1月—2017年12月期间收治的105例外伤性血气胸患者为例，探讨负压引流球管的应用效果，现将报道如下。

1  资料与方法

1.1  一般资料

纳入在南通市通州区人民医院胸外科因外伤性血气胸行胸腔闭式引流的患者105例。方……