胸腔闭式引流一次性水封瓶更换时间的探讨

目的:研究胸腔闭式引流一次性水封瓶更换时间与胸腔感染的相关性,探讨一次性水封瓶的最佳更换时间.方法:对240例行胸腔闭式引流且排除胸腔感染病人,使用随机数字表分为A、B、C、D 4组,每组60例,A组每天更换水封瓶1次,B组每3 d更换1次,C组每周更换1次,D组为使用超过1周至拔管.追踪监测一次性水封瓶内生理盐水和胸腔引流液,有细菌生长则对该病例停止实验,同时对此240例病人的胸腔积液或胸腔引流管前端2 cm进行细菌培养,最后进行统计学分析.结果:一次性水封瓶生理盐水的细菌培养均为阴性,4组水封瓶中胸腔引流液的细菌培养结果阳性16例,共检出细菌6种,各组培养阳性率比较,差异无统计学意义(P＞0.05);对此240例病人的胸腔积液和胸腔引流管前端2 cm进行细菌培养,234例无细菌生长,6例细菌培养阳性.结论:在严格无菌操作下,对于胸腔引流管留置时间较长的病人,每周更换1次水封瓶并不会增加胸腔内感染及水封瓶内细菌定植的机会.

Study on the replacing time of water-sealed bottle of thoracic cavity drainage patients.

Objective：To investigate the relation between the replacing time of water-sealed bottle and the thoracic cavity infections,and determine the optional time for replacement.Methods： 240 patients with closed drainage of pleural cavity and without thoracic infections were randomly divided into 4 groups.Group A ： replacement of water-sealed bottle every day;group B ： replacement of bottle every 3 days;group C： replacement of bottle every week;group D ： keeping water-sealed bottle over a week until the removal of chest tube.The normal saline and drainage fluid in the water-sealed bottle was cultured separately.When bacterium was found in the drainage fluid,the thoracic transudate and the fluid at the end of the tube was cultured simultaneously.Results Bacterium was not found in normal saline in the one-off water-sealed bottle.6 species of bacteria were found from 16 cases in drainage fluid.The difference of bacteria positive percent among the 4 groups is not significantly（P0.05）.Bacteria were found in the thoracic transudates and the fluid at the end of the chest tube of 6 patients,while others are negative.Conclusion： It would not increase the risk of thoracic cavity infection and bacterium reproduction in water-sealed bottle to replace the bottle once a week for those patients requiring chest tube placement and ongoing more than a week,while asepsis was strictly implemented.