The Value Of Gas Partial Pressure Evaluation In Pleural Space To Treatment Of Pneumothorax Patients

To study the value of gas in pleural space partial pressure evaluate in pneumothorax patients, discuss the relation of [Pp(CO2)],[Pp(O2)],[Pa(O2)]and[Pa (CO2)]. Determine the tape of pneumothorax for further treatment.MethodsThe patients with intercostal tube and water seal bottle percutaneous drainage, but drainage tube blocking and ipsilateral lung is not reexpansion. Positioning under the CR guiding for the puncture point, extract the gas in pleural space twice, do gas partial pressure evaluate and arterial blood gas analysis of radial artery at the same time.According to the pleural space and arterial blood gas analysis of gas in accordance with [Pp (CO2)],[Pp (O2)],[Pp (CO2)]/[Pp (O2)],[Pp (CO2)]and[Pa (CO2)]. Determine different type of pneumothorax in patients with the blocked drainage tube, choose the way to treatment. Reference①closed pneumothorax: PpCO2>40mmHg,PpCO2> PaCO2, PpO2<40mmHg, PpCO2/PpO2>1;②trafic pneumothorax PpCO2<40mmHg, PpCO2=PaCO2, PpO2>100mmHg, PpCO2/PpO2<0.4;③tension pneumothorax:PpO2about60mmHg PpCO2<40mmHg PpCO2=PaCO2,0.4<PpCO2/PpO2<1.Determine the type of patients with pneumothorax, take the appropriate treatment.Result1. According to the results of the first gas in pleural space analysis found10cases of traffic pneumothorax,3cases of tension pneumothorax,36cases of closed pneumothorax.6cases of the first result found36cases of closed pneumothorax in the second found the result according to the traffic pneumothorax. The reason is that when taking part of the gas, the pleural space pressure to reduce, not repair the breaches of the re-opening, the gas re-enter the pleural space, it performance of trafic pneumothorax when the second time.2.49patients arterial blood gas analysis results of the individual has obvious differences PaO2is37.8-153mmHg, PaCO2is27.23-86.94mmHg. Mainly due to the baseline with the patients of the lung function and gas ventilation, ventilation/perfusion, and diffusion of the severity and so on. But the good of the individual difference between PaCO2and PpCO2for judging the value of a certain type of pneumothorax.3.30cases of closed pneumothorax take the exhaust treatment. One of which extraction of lung reexpansion in11cases (36.67%), reexpansion after the second extraction in14cases (46.67%), the third exhaust reexpansion4cases (13.33%).1case of COPD is4times,after the review X-ray, suffering no significant changes in lung compression area, sending the gas check PpO2is156mmHg, PpCO2is36.8mmHg,show trafic pneumothorax.29(96.67%) patients suffering from chest X-ray observation of24-hour review of complete reexpansion lung, removal of central venous catheter.15cases of traffic pneumothorax in5patients who relapsed, send to thoracic surgery VATS treatment, and the other10cases were closed intercostal tube drainage for treatment of water-sealed bottle.3cases of tension pneumothorax take closed drainage treatment.Conclusion1. Based on the chest of oxygen and carbon dioxide partial pressure gas measurement, combined with blood gas analysis, patients can accurately evaluate the type of pneumothorax.2. Once the chest space for gas analysis to determine the type of pneumothorax has some limitations and errors. Only by repeatedly imaging data combined with inspection of gas in order to accurately evaluate the type of pneumothorax.3. Pneumothorax patients by analyzing the type, adopt appropriate measures will exhaust good effect in patients receiving minimally invasive treatment.