超声引导下中心静脉导管穿刺真空负压引流胸腔积液的临床应用

目的探讨超声引导下中心静脉导管穿刺置管并真空负压引流对胸腔积液患者的应用价值。 方法选取2015年2月至2019年12月就诊于西安交通大学第二附属医院的胸腔积液患者156例。根据穿刺方法不同将研究对象分为对照组78例，观察组78例。观察组行超声引导下胸腔穿刺置管引流术，对照组行常规胸腔穿刺置管引流术。比较2组患者的穿刺成功率、穿刺并发症的发生率、引流有效率及平均引流时间等。 结果观察组穿刺成功率为98.72%，明显高于对照组的88.46%（χ²=6.84，P=0.01）；观察组穿刺并发症发生率为6.41%，明显低于对照组的17.95%（χ²=4.85，P=0.03）。观察组的引流总有效率为84.42%，高于对照组的69.59%，2组比较差异有统计学意义（χ²=4.59，P=0.03）。观察组平均引流时间为（3.40±1.11）d，明显低于对照组的（4.03±1.12）d，2组比较差异有统计学意义（t=3.53，P=0.00）。 结论超声引导下中心静脉导管穿刺置入并真空负压引流应用于胸腔积液治疗，可提高穿刺成功率，减少穿刺并发症，提高引流效果，值得临床推广应用。

Vacuum negative pressure drainage of pleural effusion by ultrasound-guided thoracentesis and central venous catheterization

ObjectiveTo assess the efficacy of vacuum negative pressure drainage of pleural effusion by ultrasound-guided thoracentesis and central venous catheterization. MethodsA total of 156 patients with pleural effusion who were admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from February 2015 to December 2019 were retrospectively analyzed. According to the puncture method, the subjects were divided into either a control group (78 cases) or an observation group (78 cases). The observation group underwent ultrasound-guided thoracentesis catheterization and drainage, and the control group underwent conventional thoracentesis catheterization and drainage. The success rate of puncture, the incidence of puncture complications, the effective rate of drainage, and the average drainage time in the two groups were compared. ResultsThe puncture success rate in the observation group was 98.72%, which was significantly higher than that of the control group (88.46%; χ²=6.84, P=0.01). The incidence of puncture complications was significantly lower in the observation group than in the control group (6.41% vs 17.95%, χ²=4.85, P=0.028). The total effective rate of drainage was significantly higher in the observation group was 84.42%, which was higher than 69.57% in the control group (84.42% vs 69.57%, χ²=4.59, P=0.03). The average drainage time was significantly shorter in the observation group than in the control group (3.40±1.11 days vs 4.03±1.12 days, t=3.53, P=0.00). ConclusionUltrasound-guided central venous catheter placement and vacuum negative pressure drainage can be used to treat pleural effusions, which can increase the success rate of puncture, reduce puncture complications, and improve the drainage effect.