| Pleural effusion is one of the most common diseases of Respiratory System. Chest drainage with the central venous catheter( CVT) in pleural cavity is the most commonly used method in clinical. However, thoracic drainage devices matching with the central venous catheter are lack in health care market. Selfmade simple closed thoracic drainage devices have many shortcomings in clinical application, Which is complex in structure, inconvenient to operate, poor comfort, easy to reflux and others. How to reduc the clinical workload, improve comfort, reduce complications caused by gas-liquid reflux is an important problem that need to be addressed in clinical.Therefore, we developed a modified disposable closed thoracic drainage bag(Patent No.:ZL 200920255142.7)to meet clinical needs. It has improved significantly in the safety and practicability than Other drainage devices.Objective:Pleural effusion of the observation group was drained with disposable closed thoracic drainage bag. And to evaluate its safety and practicality by compared with selfmade water-sealed drainage bottle in order to supply fundamental basis for clinical application.Methods: In this experiment, we selected 100 patients with malignant pleural effusion, hospitalized for treatment in the Department Respiratory Medicine (2009.10～2010.12). 68 patients were male and 32 were female; Aged 28 to 78 years, mean age (59.1±12.5) years; KPS score 50 to 90, the average score (73.8±11.4); Pneumothorax, chest infection, leakage and non-malignant pleural effusion were ruled out.They were randomly divided into two groups of the observation group and control group (50 cases in each group) according to time of hospitalization.Observation group: To be treated by using the central venous catheter (CVT) and disposable closed thoracic drainage bag. To keep it aseptic in the whole process. The first time,drainage was not mor than 1000 ml;rate of 50ml/min; The second time,pleural effusion was drained completely as much as possible, and required patients to change position after the intrapleural instillation of drugs (PDD 40mg + IL-Ⅱ200 million units) in order to drugs can be distributed throughout uniformly in the pleural cavity and retained for 48 hours, then pleural effusion would be drained completely as much as possible again. Drain tube could be pull out if drainage was less than 50ml for 24 hours and confirmed by the B-mode ultrasound. If drainage was more than 50ml for 24 hours ,drugs would be instilled again, whether the intrapleural instillation of drugs (PDD 40mg + IL-Ⅱ200 million units) needed to be repeated according to the drainage , the amount of PDD was not more than 160mg,then valuated.Control group: To be treated by using the central venous catheter (CVT) and selfmade water-sealed drainage bottle closed thoracic drainage. To keep it aseptic in the whole process.Drainage, speed, treatment of the two groups was the same.Results:1.The comparison of the incidence of pneumothorax :The observation group included 50 goats,chest drainage for 200 times,the cases of pneumothorax were 7, the occurence rate was 3.5%; in the control group included 50goats, chest drainage for 300 times, the cases of pneumothorax were 36, the occurence rate was 12%. There was significant statistical difference between the two groups, P <0.05.2.The comparison of the incidence of chest infection: The observation group included 50 goats,the case of chest infection was 0, the occurence rate was 0%; in the control group included 50 goats, the case of chest infection was 1, the occurence rate was 2%. There was no significant statistical difference between the two groups, P> 0.05.3.The comparison of the incidence of pulmonary edema: The observation group and the control group included 50 goats each, the case of pulmonary edema was 0, the occurence rate was 0%; in the control group, the case of pulmonary edema was 1, the occurence rate was 2%; There was no significant statistical difference between the two groups, P> 0.05. 4.The comparison of the effective rate of drainage:The observation group included 50 goats, 40 cases were effective,the effective rate was 80%,in the control group included 50 goats, 35 cases were effective,the effective rate was 75%,There was no significant statistical difference between the two groups, P > 0.05.5.The comparison of the incidence of reflux: The observation group included 50 goats,chest drainage for 200 times, the incidence of reflux were 6 times, the incidence of reflux was 3%;In the control group included 50 goats,chest drainage for 300 times, the incidence of reflux were 33 times,t the incidence of reflux was 11%; There was significant statistical difference between the two groups, P <0.05.6.The comparison of the disconnected rate of connector,The comparison of the positive rate of bacterial in Murphy's dropper:The observation group included 50 goats, connecting the connector for 200, 4 cases of them were disconnected, the disconnected rate was 2%; In the control group included 50 goats, connecting the connector for 300, 30 cases of them were disconnected, the disconnected rate was 10 %; There was significant statistical difference between the two groups, P<0.05.Chest drainage for 200 times in the observation group, 3 cases were positive in Murphy's dropper, the positive rate of bacterial was 1.5%; Chest drainage for 300 times in the control group, 27 cases were positive in Murphy's dropper, the positive rate of bacterial was 9%;There was significant statistical difference between the two groups, P <0.05.7.The comparison of the incidence of tube blockage: In the observation group, chest drainage for 200 times, drainage tube was blocked for 30 times, the incidence of blockage was 15%; In the control group,chest drainage for 300 times,drainage tube was blocked for 93 times, the incidence of blockage was 31%; There was significant statistical difference between the two groups, P <0.05.8.The comparison of the successful rate of deoppilation: Drainage tube was blocked for 30 times in the observation group, and the cases of deoppilation were 27, the successful rate of deoppilation was 90%; drainage tube was blocked for 93 times in the observation group, and the cases of deoppilation were 62, the successful rate of deoppilation was 66.7%; There was significant statistical difference between the two groups, P <0.05.9.The comparison of the satisfaction rate: The observation group included 50 goats, 40 cases of goats were willing to accept chest drainage by disposable closed thoracic drainage bag, the rate of satisfaction was 80%; in the control group included 50 goats, 25 cases of goats were willing to accept chest drainage by the drainage bottles, the rate of satisfaction was 50%; There was significant statistical difference between the two groups, P <0.05.10.The comparison of the average consumption time to install drainage devices: The observation group included 50 goats, the average consumption time to install drainage devices was 52.99±12.5 (s); in the control group included 50 goats, the average consumption time to install drainage devices was 313.87±66.7(s); There was significant statistical difference between the two groups,P <0.05.Conclusion:1.The incidence of pneumothorax in the observation group was 3.5%; The incidence of pneumothorax in the control group was 12%; There was significant statistical difference in the incidence of pneumothorax between the two groups, P<0.05. Hint: The incidence of pneumothorax in the observation group is significantly lower than that of the control group. Disposable closed thoracic drainage bag is more safer.2.The incidence of chest infection in the observation group was 0%; but 2% in the control group, There was no significant statistical difference in the incidence of chest infection between the two groups, P>0.05. The incidence of pulmonary edema in the observation group was 0%; but 2% in the control group, There was no significant statistical difference between the two groups, P>0.05. Hint: The incidence of chest infection and pulmonary edema is no difference between the two groups , no difference in safety.3.The effective rate was 80% in the observation group,the effective rate was 75% in the control group,There was no significant statistical difference between the two groups, P>0.05. Hint: no difference in efficacy.4.The incidence of reflux was 3%in the observation group,the incidence of reflux was 11 % in the control group; There was significant statistical difference between the two groups,P<0.05.Hint:The incidence of reflux in the observation group is significantly lowerthan that of the control group,reducing the factors that lead to chest infections,disposable closed thoracic drainage bag is more safer than drainage bottle.5.The disconnected rate was 2% in the observation group,but 10 % in the control group; The observation group,the positive rate of bacterial in Murphy's dropper was 1.5%; but 9% in the control group;There was significant statistical difference between the two groups, P<0.05.Hint: The disconnected rate and the positive rate of bacterial in observation group is lower than that in the control group, airtight of disposable closed thoracic drainage bag is significantly better than that in the control group, more safer in clinical.6.The incidence of blockage was 15% in the observation group,the incidence of blockage was 31%in the control group;There was significant statistical difference between the two groups,P<0.05. The successful rate of deoppilation was 90% in the observation group; but 66.7% in the control group; There was significant statistical difference between the two groups,P<0.05.Hint: The incidence of blockage is significantly less than that in the control group, but the successful rate of deoppilation is significantly higher, Disposable closed thoracic drainage bag is more unobstructed, convenient and practical in clinical.7.The rate of satisfaction in the observation group was 80%, but 40% in the control group;There was significant statistical difference between the two groups, P<0.05.The average consumption time to install drainage devices in the observation group was 52.99±12.5(s);the average consumption time to install drainage devices in the control group was 313.87±66.7(s); There was si gnificant statistical difference between the two groups, P<0.05. Hint: Disposab le closed thoracic drainage bag is more comfortable,so it is acceptable,and the average consumption time is less than that of the control group,it is more convenient and practical in clinical.This study demonstrates that modified disposable closed thoracic drainage bag,compared with selfmade water-sealed drainage bottle,is a more simple in structure,easy to operate,comfort,cheap,practical and safer new drainage device,and its both urine collection features.It has vast chinical application and promotion. |
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