| Malignant tumors such as lung cancer, breast cancer, etc.transferring topleura lead to malignant pleural effusion. Discomfortable symptoms, forexample, chest distress, short-winded and dyspnea, easily appear, and thepatients’ condition aggravate rapidly in short time with bad prognosis.Nowadays central venous catheters are imbedded into thoracic cavity aftertype-B ultrasonic or CT locating. However, there are short of specified pleuraleffusion gathering units in practice which are fit for central venous catheters.Usually clinicians make hydrothorax gathering units by themselves accordingto their experience, for instance, drainage bottle, drainage bag. These units arecomplicated and uncomfortable, which are insufficient in safety and drainage.Therefore, it is in dire need of a kind of pleural effusion gathering unit whichis advanced in convenience, comfort, safety and drainage. Because of this, weinvent disposable multifunctional drainage bag(Patent No.:ZL200920255142.7), which supplies the gap in clinical usage.Objective: Contrastively studying the safety and effectiveness ofdisposable multifunctional drainage bag and ordinary disposable drainage bagin drainaging malignant pleural effusion.Methods: There were120patients hospitalized in the DepartmentRespiratory Medicine of The Forth Hospital of Hebei Medical University fromFeb.2010to Dec.2011, who were all found cancer cell by the hydrothoraxexfoliative cytology inspection and diagnosed malignant pleural effusion.They were proved to having moderate or severe pleural effusion by type-Bultrasonic or CT. There were78men and42women, aged from26to74,whose mean age was (57.2±11.2) years old. Their KPS marked from60to95, the average mark was (78.8±9.6). They took part in the experiment of theirown accords and subscribed informed consents. The patients who had suchcomplications as heart failure, hepatic failure, renal failure, lymphangitiscarcinomatosa, large atelectasis, mediastinum immobilization, superior venacava echmasis, pneumonia, pulmonary embolism and severe hypoproteinemia,were excluded.120patients were assigned to experimental group and controlgroup via randomization, each having60patients. The two group all appliedthe method of Seldinger to imbed central venous catheter into thoracic cavity.Experimental group, connected disposable multifunctional drainage bag tocentral venous catheter, then drainaged and collected pleural effusion. Controlgroup, connected ordinary disposable drainage bag to central venous catheter,then drainaged and collected pleural effusion.The two groups all used the method of sustained pleural effusiondrainage. When the drainage halted, Cisplatin,40mg, together withrecombinant human interleukin-2,1million units, were poured into thoraciccavity. Finally, used heparin natrium brine3ml to seal the catheter. Enjoinedthe patients to alter their positions for the sake of the drugs well-distributed inthe thorax. The drugs were in the thorax for48to72hours, then drainedpleural effusion completely. When the drainage halted, repeated themanipulations above mentioned. Pleural effusion drainage sustained for24hours. If the drainage amount was less than100ml，it was proved that therewas tiny or little effusion, then extracted the catheter. Contrasted andevaluated such aspects of the two groups, the time of installation or change ofdrainage bag, the incidence of pneumothorax, liquid contamination in thedrainage bag, the effective rate of remedy, the patients’ satisfactory ratio, theincidence of drainage tube blockage, the successful rate of dredge and theincidence of connective-tube’s dropping.Results:1The time of installation or change of drainage bag: There were60patients inthe experimental group whose effusion were drained for350times, the timewas (9-24) seconds, the mean time was (14.88±3.71) seconds. There were60 patients in the control group whose effusion were drained for340times, thetime was (55-124) seconds, the mean time was (73.50±5.85) seconds. Therewas statistical difference between the two groups. The experimental group wasobviously less than the control group in the time of installation or change ofdrainage bag (p <0.05).2The incidence of pneumothorax: There were60patients in the experimentalgroup. Pneumothorax happened to1patient. The incidence was1.7%. Therewere60patients in the control group. Pneumothorax happened to8patients.The incidence was13.3%. There was statistical difference between the twogroups. The experimental group was obviously less than the control group inthe incidence of pneumothorax(p <0.05).3The incidence of liquid contamination in the drainage bag: During theremedy, pleural effusion in the drainage bag was submitted to do germicultureevery7days. There were60patients in the experimental group, where liquidwas submitted to do germiculture for151times, and the positive outcomeswere6times. The incidence was4.0%. There were60patients in the controlgroup, where liquid was submitted to do germiculture for162times, and thepositive outcomes were16times. The incidence was9.9%. There wasstatistical difference between the two groups. The experimental group wasobviously less than the control group in the incidence of liquid contaminationin the drainage bag (p <0.05).4The effective rate of remedy: There were60patients in the experimentalgroup,27complete remission(CR),16partial remission(PR),17invalidation.The effective rate was71.7%. There were60patients in the control group,26complete remission(CR),19partial remission(PR),15invalidation. Theeffective rate was75%. There was no statistical difference between the twogroups. There was no visible difference between the experimental group andthe control group in the effective rate of remedy (p>0.05).5The patients’ satisfactory ratio: There were60patients in the experimentalgroup,42highly satisfactory,16satisfactory,2dissatisfactory. The satisfactoryratio was96.7%. There were60patients in the control group,30highly satisfactory,21satisfactory,9dissatisfactory. The satisfactory ratio was85%.There was statistical difference between the two groups. The experimentalgroup was obviously more than the control group in the patients’ satisfactoryratio (p <0.05).6The incidence of drainage tube blockage and the successful rate of dredge:There were60patients in the experimental group where drainage tubeblockage happened to7patients. The incidence was11.7%. There were60patients in the control group where drainage tube blockage happened to8patients. The incidence was13.3%. There was no statistical differencebetween the two groups and there was no visible difference between theexperimental group and the control group in the incidence of drainage tubeblockage (p>0.05).6patients had successful dredges in the experimentalgroup. The successful rate was85.7%.2patients had successful dredges in thecontrol group. The successful rate was25%. There was statistical differencebetween the two groups and the experimental group was obviously more thanthe control group in the successful rate of dredge(p <0.05).7The incidence of connective-tube’s dropping: There were60patients in theexperimental group where connective-tube’s dropping happened to nobody.The incidence was0%. There were60patients in the control group whereconnective-tube’s dropping happened to8patients. The incidence was13.3%.There was statistical difference between the two groups. The experimentalgroup was obviously less than the control group in the incidence ofconnective-tube’s dropping (p <0.05).Conclusion: In the course of malignant pleural effusion remedy, thanordinary disposable drainage bag, disposable multifunctional drainage bag hadevidently less time of installation or change of drainage bag, less incidence ofpneumothorax, liquid contamination in the drainage bag and connective-tube’sdropping. It was more convenient and satisfactory to the patients who sufferedfrom malignant pleural effusion. It had more successful rate of dredge. Butthere were no obvious differences in the remedial effect and incidence ofdrainage tube blockage. Disposable multifunctional drainage bag is a new kind of hydrothoraxdrainage and gathering unit, which is not only effective and inexpensive, butalso briefer, snugger and safer. |
PDF Full Text Request