| Pericardial effusion is one of the common clinical and life-threateningdisease, is a kind of pericardial disease caused by complicated factors. Withthe increase in risk factors lead to tumor, in recent years, showed a rising trendof malignant pericardial effusion proportion.Among them, with pericardialmetastasis of lung cancer is the most common, when the lymph and venousreturn obstruction leads to rapid cardiac pericardium due to accumulation offluid, can lead to shortness of breath, palpitation, cardiac tamponadesymptoms, can endanger life, the most direct and effective treatment measuresfor pericardial decompression, including B ultrasound guided central venouscatheter in the pericardium puncture catheter drainage because of itsconvenience, security and other advantages is widely used in clinic.At present,the clinical lack of catheter and central venous phase matching fluid drainagecollection device, usually, the medical staff will use hand medical materialself-made simple effusion drainage collection device, such as homemadedrainage, drainage bag, this homemade fluid drainage in production process iscomplicated, time-consuming, easy pollution, poor drainage effect of issuessuch as the poor collection device.Disposable multifunctional Division Iindependent invention of the drainage bag (Patent No.: ZL200920255142.7)to solve the above problems, the safety and efficacy in the pericardial effusiondrainage collection process has been significantly improved.Objective: explore disposable multifunctional drainage bag connectedcentral venous catheter drainage collection malignant pericardial effusionsafety and efficacy compared with the one-time ordinary drainage bag.Methods: The experiment collected40cases of hospitalized patients in the Fourth Hospital of Hebei Medical University, Department of RespiratoryMedicine, were confirmed by pericardial effusion cytology find cancer cellsand diagnosis of malignant pericardial effusion, including12women from2011-3to2013-1doctor patients,28males; aged30to72years, mean age55.5±8.5years; KPS score≥60;-large pericardial effusion confirmed byultrasound, the primary tumor of24cases of lung cancer, breast cancer, gastriccancer four cases, three cases of esophageal cancer, three cases of unexplainedexclude pericardial effusion in patients with aortic dissection; the clottingdisease patients can not be corrected, is the line of anticoagulant therapy,bleeding tendency or platelets less than50x109/L pericardial effusion; liverand kidney function is located in the posterior wall or localized pericardialeffusion; leakage of pericardial effusion caused by heart failure,hypoproteinemia; non-neoplastic effusion caused by infection factors; failureand other diseases. Order of hospitalization were randomly divided into2groups, experimental and control groups. Experimental group: ultrasoundlocalization Seldinger technique placed ARROW central venous catheter linepericardiocentesis catheter drainage connection disposable multifunction thedrainage bags drainage collection pericardial effusion, the whole process isstrict compliance with aseptic. The slow continuous drainage of pericardialeffusion clean drainage speed5/min, to avoid a short period of time a largenumber of drainage caused by acute pulmonary edema, congestive heartfailure, arrhythmias, and other complications. Beware package effusionsignificantly decreased or disappeared, pericardial injection of cisplatin20mg(total cisplatin calculated according to body surface area, the maximumamount of no more than160mg) and interleukin-II40million units, Folder48hours of the completion of the drainage tube. Again after continuousdrainage until the drainage of pericardial effusion, clean up, repeat thetreatment. Such as24-hour drainage volume of less than25ml and byB-ultrasound to determine the minimal amount of pericardial effusion ordisappear, you can unplug the drainage tube. Control group: at the ultrasoundlocalization Seldinger technique into the ARROW central venous catheter pericardiocentesis drainage catheter, by means of2ml syringe jacket tube,disposable ordinary drainage bag with central venous catheter, the drainagecollection pericardial effusion. Strict compliance with aseptic the pericardialdrainage injection process is the same as the experimental group. Disposablemultifunctional drainage bag and disposable ordinary drainage bag to wearreplaced once every six days.Compare and contrast the two groups of patients with pericardial effusiondrainage in the treatment process, drainage bag installation or replacementtime, multifunctional drainage bag and homemade ordinary drainage bagconnecting tube rate, jam and dredge results, the therapeutic effect ofmalignant pericardial effusion, gas pericardial regurgitation rate of drainagebag liquid contamination rate, the degree of patient satisfaction.Results:1The time of installation or replacement of drainage bag: multifunctionaldrainage bag installation and replacement in the experimental group,20casesof patients with pericardial effusion, received a total of51times, every timeyou install or replace for14to36seconds, an average of25.75±10.81seconds; control group received a total of20cases of patients with pericardialeffusion the ordinary drainage bag installation and replacement of53times,every time you install or replace55-124seconds,74.50±6.85seconds, thetime of installation and replacement of drainage bag two groups statisticallysignificant difference between the installation and replacement of theexperimental group was significantly lower than the control group（P＜0.05）.2Connecting pipe off incidence:in the experimental group of20patients,the connecting pipe off0cases, the incidence rate of0%;20patients of thecontrol group, the connecting pipe off the four cases, the rate was20%.Incidence connecting pipe off the two groups was statistically significant, theexperimental group the connection pipe off incidence was significantly lowerthan the control group (p <0.05).3Gas reflux incidence: the experimental group,20cases of patients withpericardial effusion and gas reflux occurs0cases was0%in the control group, 20cases of patients with pericardial effusion the gas reflux occurs three cases,the incidence of15%, gas reflux incidence of two groups, a statisticallysignificant difference, gas reflux incidence of the experimental group wassignificantly lower than the control group（P＜0.05）.4Drainage tube of liquid contamination rate: the experimental group,20cases of patients with pericardial effusion examination and bacteriologicalculture of33times, both bacterial culture negative drainage tube liquidcontamination rate was0%; in the control group,20cases of patients withpericardial effusionbacteriology41times for inspection, drainage tube ofliquid culture positive in8cases, Pseudomonas aeruginosa4cases,3cases ofS. aureus, E. coli1cases, the drainage tube the liquid contamination rate of20%, liquid pollutionrates of the two groups have a significant statisticaldifference, the experimental group drainage tube of liquid contamination ratewas significantly lower than the control group（P＜0.05）.5Drainage tube blockage rate, dredge success rate: four cases occurred inthe experimental group,20cases of patients with pericardial effusion, drainagetube blockage, the blockage was20%; five cases in the control group of20patients with pericardial effusion, drainage tube blockageblockage was25%,the two groups was not statistically significant, the experimental and controlgroups drainage tube blockage incidence of no significant difference （P>0.05). The experimental group dredge to the success of the four cases, asuccess rate of100%; the control group dredge successful one cases, a successrate of20%. Dredge the success rate of the two groups was statisticallysignificant, the drainage tube of the experimental group dredge success ratewas significantly higher than that in the control group（P＜0.05）.6Efficient treatment after pericardial administration:20patients in theexperimental group,13cases of complete remission, partial remission in6cases, the total effective19cases, an effective rate of95%; control group of20patients,12cases of complete remission, improvedsix cases, the total effectivein18cases, the effective rate was90%， the two groups showed nostatistically significant differences（P>0.05）. 7The rate of patients satisfaction: experimental group of20patients withpericardial effusion, satisfied with the19cases of multi-functional drainagebag, the satisfaction rate of95%; control group,20cases of patients withpericardial effusion, the ordinary drainage bag satisfaction of five cases, thesatisfaction rate of25%,two groups have a significant statistical difference,patient satisfaction rate of the experimental group was significantly higherthan that of the control（P＜0.05）.Conclusion: In the course of treatment of malignant pericardial effusion,multifunctional drainage bag installation or replacement of the time, theexpulsion rate of drainage tube blockage rate, gas regurgitation incidence,pollution was less than ordinary drainage bag; multifunctional drainage bagdredge success rateand patient satisfaction is higher than ordinary drainagebag, to confirm the safety and efficacy of disposable multifunctional drainagebag clinical applicationsThe study shows that disposable multifunctional drainage bag malignantpericardial dffusion treatment procdss better than the ordinary drainagebag,convenient method of clinical installation or replacement confined good,safe, easy to wear beautiful, a significant effect of drainage, malignantpericardialfluid therapy in central venous catheter match dedicated drainagebag should be actively promoted and applications. |
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