原发性和继发性自发性气胸插管开胸前后临床及动脉血气参数的研究

Subhajit Sen, S. Kundu, S. Chatterjee
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摘要

气胸是一种常见的呼吸急症,在许多情况下需要积极干预,特别是气管开胸术。本研究的目的是了解导管开胸术后原发性气胸和继发性气胸的临床及动脉血气参数在不同时间间隔的变化。其中原发性自发性气胸11例,继发性自发性气胸19例。临床参数:脉率、血压、呼吸频率、血氧饱和度。ABG分析:pH、二氧化碳分压(pCO2)、氧气分压(pO2)、AaDO2。时间间隔:开胸前、开胸后1小时、开胸后24小时、拔管后。年轻患者多发于PSP(平均34.18),老年患者多发于SSP(平均52.68),差异有统计学意义(P=0.001)。两组患者的脉搏率、呼吸率变化均有统计学意义(P<0.001),两组患者的心动过速和呼吸急促均有所减轻。SSP组舒张压(P<0.01)、SO (P<0.05)。与取胸1小时、24小时和取胸时相比,开胸前的平均动脉压升高。SSP组差异有统计学意义。PSP组54.54%的患者在给予胸管前出现低氧血症,而插管开胸1 h后仅有18.18%的患者出现轻度低氧血症。SSP组68.42%患者术后出现低氧血症,拔管后26.31%出现轻度低氧血症。两组患者其他血气参数均无明显变化。管式开胸对原发性和继发性气胸的影响主要体现在临床参数上,而不是血气参数上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A study on clinical and arterial blood gas parameters before and after tube thoracostomy among cases of primary and secondary spontaneous pneumothorax
Pneumothorax is a common respiratoryemergency that requires active interventions in many cases specially Tube thoracostomy. Objective of the present study is to find out changes in clinical and arterial blood gas parameters in primary and secondary pneumothorax following tube thoracostomy at different time intervals.Total 30 cases, Primary spontaneous pneumothorax (PSP) 11 and secondary spontaneous pneumothorax (SSP) 19. Clinical parameters: pulse rate, blood pressure, respiratory rates, oxygen saturation (SpO2). ABG analysis: pH, partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), AaDO2. Time interval: pre tube thoracostomy, 1hour and 24hours after thoracostomy and after tube removal. PSP was found more in young patients (mean 34.18), SSP in older patient (mean 52.68), (P=0.001). Among clinical parameters statistically significant changes were seen in pulse rate, (P<0.001) respiratory rate (P<0.001) in both groups, in both cases tachycardia and tachypnea decreased. Diastolic blood pressure in SSP group (P<0.01), SO in SSP group (P<0.05). There is an increase in mean arterial pressure from pre thoracostomy compared to in 1hr, 24hr and at removal. Which statistically significant in SSP group.In PSP group hypoxaemia was present in 54.54% patients before giving chest tube, after 1 hour of tube thoracostomy only 18.18% cases had mild hypoxaemia. In SSP group 68.42% cases presented with hypoxaemia initially, after tube removal 26.31% cases had mild hypoxaemia.No significant changes in other blood gas parameters were seen in either groups. The impact of tube thoracostomy on primary and secondary pneumothorax are mainly reflected on clinical parameters rather than blood gas parameters.
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