一次性中心静脉导管置管在治疗胸膜疾病中的应用

目的探讨一次性中心静脉导管置入胸腔治疗胸膜疾病的可行性和适应证。方法在全身治疗的情况下。根据胸膜疾病的不同，局麻下选择不同的穿刺部位行一次性中心静脉导管置入胸腔内引流气体或液体。并从导管内注药治疗胸膜疾病。结果一次性中心静脉导管置管治疗胸膜疾病38例。手术时间15—25min。平均20min，出血1．5ml，平均3瑚。术后均能达到充分引流气体及液体的目的。无感染、脱管、胸水渗漏、皮下气肿、复张性肺水肿等并发症。除4例大量恶性胸腔积液患者因原发疾病死亡外，8例大量恶性胸腔积液患者部分缓解，其余均痊愈。结论 中心静脉导管置管能充分引流胸膜腔内气体或液体，减少手术创伤，并能完成导管内注药治疗胸膜疾病，便于操作。具有安全、操作简单、舒适耐受、疗效好等优点，值得临床推广应用。

The experience in pleural diseases treated with central venous catheter

Objective To explore feasibility and indication of treatment of pleural diseases with disposal central venous catheter. Methods In general treatment, the insertion of central venous catheter into pleural cavity at different sites under local anesthesia for administration of drugs and drainage of gas and liquid in treatment of pleural diseases was carried out in 38 cases. Results The operative time for insertion of central venous catheter was from 15 to 25 minutes with an average of 20 minutes. Blood loss in this operation was 1 to 5 ml with an average of 3 ml. Drainage can be well performed after this operation without any complication of infection, getting out of catheter, leakage of effusion, pneumoderma and reexpan- sion pulmonary edema. Four patients with massive malignant pleural effusion died of primary disease, eight patients with massive malignant pleural effusion were partially remitted after treatment and remaining cases were completely cured. Conclusion The disposal central venous catheter is applied for drainage of gas and liquid from pleural cavity, and this procedure can decrease the trauma caused by operation, and drugs may be given through the catheter for treatment of pleural diseases.