胸腔内置中心静脉导管治疗结核性胸膜炎的观察与护理

目的探讨胸腔置入中心静脉导管(central venous catheterization,CVC)持续引流治疗结核性胸膜炎的疗效和护理。方法将229例结核性胸膜炎患者随机分为两组:治疗组115例,采用CVC置入胸腔持续引流胸腔积液;对照组114例,采用常规胸腔穿刺抽液。比较两组患者治疗后的焦虑程度、疼痛程度、有无肺复张后肺水肿及气胸、胸腔积液吸收时间、胸膜增厚粘连、住院时间及医疗费用等。结果治疗组患者焦虑与疼痛程度明显低于对照组,比较有显著性差异(P<0.05);治疗组胸腔积液吸收快,住院时间短,胸膜粘连及胸膜增厚、气胸发生率低,医疗费用低,和对照组比较有显著性差异(P<0.01);但治疗组患者肺复张后肺水肿发生率和对照组比较,无显著性差异(P>0.05)。结论胸腔置管持续引流治疗结核性胸膜炎疗效确切,操作简便,创伤小,安全性高。

Central Venous Catheter Placement in Thoracic Cavity for Tuberculous Pleuritis:An Observation and Nursing Care

Objective To study the clinical effect of central venous catheterization for persistent thoracic drainage in treatment of tuberculous pleuritis and its nursing.Methods Totally 229 patients with tuberculous pleurisy were randomly divided into two groups:patients in treatment group(n= 115)were treated with central venous catheterization placement in the thoracic cavity for drainage of the pleural effusion;patients in control group(n=114)received routine thoracic puncture and drainage.Then the degree of anxiety,the degree of pain,presence of re-expansion pulmonary ede- ma and neumothorax,the time for hydrothorax absorption,the pleural thickening and adhesion, hospital stay,and costs were compared between the 2 groups.Results The degrees of anxiety and pains in the treatment group were significantly lower than those of the control group(P<0.05). The time of hydrothorax absorption,hospital stay,the rate of pleural thickening and adhesion,the rate of pneumothorax and cost of the treatment group were significantly less than those of the con- trol group(P<0.01).There was no significant difference in re-expansion pulmonary edema be- tween the 2 groups(P>0.05).Conclusion Central venous catheterization indwelling thoracic cavity is effective for tuberculous pleuritis;the procedure is simple,with less trauma and high safety.