中心静脉导管胸腔留置引流140例结核性胸腔积液临床观察

目的 探讨胸腔置入中心静脉导管持续引流治疗结核性胸膜炎的临床疗效.方法 对我院2005年6月至2010年l2月共140例结核性胸膜炎患者随机分为两组:引流组70例,采用一次性中心静脉导管置入胸腔持续引流胸腔积液;对照组70例,采用常规胸腔穿刺抽胸水.两种方法均给予强的松30 mg,1次/d口服4周,严格四联抗痨,观察其胸水吸收和并发症的发生情况.结果 置管法疗效明显优于常规法,置管法治疗的患者住院周期短、并发症少.引流组患者中65例一次置管成功,引流时间为3～5 d,2例少量出血,无1例出现气胸、继发肺部感染;常规穿刺组7～14 d胸水吸收,6例发生少量出血、4例发生小量气胸.结论 中心静脉导管胸腔留置引流治疗结核性胸膜炎疗效确切,操作简便安全,值得推广.

Clinical observation of drainage using central venous catheter in 140 patients with tuberculosis pleural effusion

Objective To explore the therapeutic effect of central venous catheter drainage on patients with tuberculosis pleural effusion.Methods 140 patients with tuberculosis pleural effusion were divided into two groups randomly in our hospital from 2005-6 to 2009-12,the drainage group and the control group both consisted of 70 patients.Patients of drainage group were treated with the method of central venous catheter drainage while the control group were treated with routine thoracocentesis.All patients were also simultaneously treated with strict quadruple anti-TB.The absorption of the effusion and complications were recorded.Results The effects of drainage were better than that of routine thoracocentesis.65 patients of drainage group were successfully inserted with the central venous catheter,and drainage time varied from 3 days to 5 days,and no one was infected while the absorption time of control group varies from 7 days to 14 days and 4 patients suffered pneumothorax.Conclusion Central venous catheter drainage is a better method for the therapy of tuberculosis pleural effusion than thoracocentesis.