老年胸腔积液患者经不同肋间胸腔闭式引流法治疗的效果观察

Observation of therapeutic effects of closed thoracic drainage via different intercostal spaces on elderly patients with pleural effusion

中文关键词: 老年  胸腔积液  胸腔闭式引流法  疗效  并发症

英文关键词: elderly  pleural effusion  closed thoracic drainage  efficacy  complication

中文摘要:

      目的 探讨不同肋间胸腔闭式引流法在老年胸腔积液患者的应用效果.方法 回顾性分析118例老年胸腔积液患者的临床资料,依据治疗方法不同分为第五肋间组(腋前线与腋后线第五肋间进行治疗)和第六七肋间组(腋前线与腋后线第六、七肋进行治疗),经倾向性匹配评分法排除混杂因素,2组各纳入52例.比较2组临床疗效、围手术期指标值、视觉模拟评分(VAS)和并发症.结果 第五肋间组的临床疗效高于第六七肋间组(P＜0.05);2组各项围手术期指标值差异无统计学意义(P＞0.05);术后12、24、36 h,2组VAS评分逐渐降低(P＜0.05),且第五肋间组术后12、24、36 h的VAS评分比第六七肋间组评分更低(P＜0.05);2组并发症发生率差异无统计学意义(P＞0.05).结论 采取腋前线与腋后线第五肋间行胸腔闭式引流术治疗胸腔积液效果相对更好,疼痛感轻,膈肌腹部脏器损伤风险小.

英文摘要:

      Objective To explore the application effects of closed thoracic drainage via different intercostal spaces on elderly patients with pleural effusion.Methods The clinical data of 118 elderly pleural effusion patients were retrospectively analyzed.According to different treatment methods,they were divided into fifth intercostal group(drainage via fifth intercostal space between the anterior axillary line and posterior axillary lines)and the sixth-seventh intercostal group(drainage via the sixth or seventh intercostal space between the anterior axillary line and posterior axillary lines).The propensity matching score method was used to exclude the confounding factors,and52 cases were included in each group.The clinical efficacy,perioper-ative indicators,visual analogue scale(VAS)score and the complications were compared between the two groups.Results The clinical efficacy in the fifth intercostal group was significantly higher than that in the sixth-seventh intercostal group(P＜0.05).There were no significant differences in various perioperative indicators between the two groups(P＞0.05).At 12,24,36 h after surgery,the VAS scores in the two groups decreased gradually(P＜0.05),and the scores in the fifth intercostal group were lower than those in the sixth-seventh intercostal group(P＜0.05).There was no statistically significant difference in the incidence of complications between the two groups(P＞0.05).Conclusion Closed thoracic drainage via fifth intercostal space between the anterior axillary line and posterior axillary lines has relatively better effect in the treatment of pleural effu-sion.It causes mild pain and has a low risk of injury to the diaphragm and abdominal organs.