The Contrastive Research Of The Safety And Effectiveness Of Disposable Multifunctional Drainage Bag And Conveen Anti-reflux Drainage Bag In The Remedy For Malignant Pericardial Effusion

Pericardial effusion is a common clinical manifestations of pericardialdisease. And a variety of causes can lead to pericardial effusion. Theproportion of malignant pericardial effusion by tumor metastasis or directinvasion is rising every year in our country. Malignant pericardial effusion isan important performance in patients with advanced cancer. Patients ofenshow symptoms of progressive worsening chest pain, shortness of breath,notable of difficulty breathing, congestive heart failure, and so on. It seriouslyaffect the patient’s quality of life, and even life-threatening. The characteristicsof malignant pericardial effusion is recurrent, intractable and bloody exuded.Currently, clinicians usually do pericardial catheterization byultrasound-guided to treatment of malignant pericardial effusion. Owing to,there are short of specified pericardial effusion gathering units in practicewhich are fit for central venous catheters. Normally clinicians makepericardial effusion gathering units by themselves according to theirexperience, such as drainage bottle, drainage bag, and so on. But, thedisadvantage of these units is the production of incovenient complex,time-consuming, and easy to fall off, low security, poor drainage effect,uncomfortable. Therefore, it’s in dire need of a kind of pericardial effusiongathering units which is a practicality, safety, comfort and drainage. For thereason that, we invent disposable multifunctional drainage bag(Patent No.: ZL200920255142.7), which supplies the gap in clinical usage.Objective: Through the comparative study on the disposablemultifunctional drainage bag and the Conveen anti-reflux drainage bag linkedwith the central venous catheter to drain the pericardial effusion, evaluate the safety and efficacy of these drainage bags in the clinical application.Methods: In this experiment, the information was collected from34patients who were hospitalized for malignant pericardial effusion in theDepartment Respiratory Medicine of The Forth Hospital of Hebei MedicalUniversity during the time of Feb.2011and Jan.2013. These were9womenand25men, aged from40to81year old, mean age (59.53±10.70) years.They were diagnosed as malignant pericardial effusion by find cancer cells inpericardial effusion cytology. Primary tumors includ the following:20case oflung cancer,4case of breast cancer,3case of esophageal cancer,3case ofstomach cancer and4unexplained case. They were confirmed by ultrasoundwith moderate or severe pericardial effusion. They took part in the experimentof their own accords and subscribed informed consents. The pericardialeffusion patients who transudate and the non-neoplastic effusion caused bypericardial infection and the pericardial effusion in the posterior wall and withaortic dissection are ruled out; As same time the pericardial effusion patientswith who clotting disorders not be corrected, accepting anticoagulant therapy,bleeding tendency or thrombocytopenia below50×109/L were excluded.The patients were randomly divided into experimental group and controlgroup. No significant difference between age groups, gender, and primarydisese due in these groups. Experimental group: Through the ultrasound, usethe Seldinger technique to position ARROW pericardiocentesis catheterdrainage, and connect the disposable multifunctional drainage bag to drain thepericardial effusion. The whole process is under aseptic manipulation. Wedrainaged the pericardial effusion continully, keeping the speed in6-10ml/min, to be avoided acute pulmonary edema, congestive heart failureand arrhythmia by drainage a lot of pericardial effusion in a short-term. Inject20mg/time of cisplatin (the total amount of cisplatin does not exceed75mg/m2) and40million units/time of interleukin-II to the pericardium, andclip the drainage tube for48hours. Then, drain the pericardial effusion untilno effusion left. If the drainage volume in the24-hour is less than50ml andthrough the identification of B-ultrasound, there is small amount of pericardial effusion, you can pull out the drainage tube. Control group: Through theB-ultrasound, use the Seldinger technique to position ARROWpericardiocentesis catheter drainage, and connect the Conveen anti-refluxdrainage bag to drain the pericardial effusion. The process and the pericardialinjection are the same with those of the experimental group. Replace once thedisposable multifunctional drainage bag or the Conveen anti-reflux drainagebag every six days.Contrasted such aspects of the two groups: the incidence ofconnective-tube’s dropping, the incidence of air reflux, the rate of fluidcontamination in the drainage bag, the incidence of congestive heart failure,the incidence of blockage and dredging, the effective rate of treatment, theoperating time-consuming, the patient satisfaction in the pericardial effusiondrainage.Results:1The incidence of connective-tube’s dropping: In the experimental group,there were105times drainage and the connective-tube’s dropping happened toone time. The incidence was1.0%. In the control group, there were109timesdrainage and the connective-tube’s dropping happened to9times. Theincidence was7.3%. There was significant statistical difference between thetwo groups, P<0.05. The experimental group was obviously less than thecontrol group in the incidence of connective-tube’s dropping.2The incidence of air reflux: In the experimental group, there were105timesdrainage and the air reflux happened to one time. The incidence of air refluxwas1%. In the control group, there were109times drainage and air refluxhappened to10times, the incidence rate was9.2%. There was significantstatistical difference between the two groups, P<0.05. The experimental groupwas obviously less than the control group in the incidence of air reflux.3The rate of fluid contamination in the drainage bag: In the experimentalgroup, there were19times of the examination of the germiculture, and nonefluid contamination was detected, the rate was0%; In the control group, therewere20times of the examination of the germiculture, there were3cases of fluid contamination. One case of them was Pseudomonas aeruginosa, one caseof them was Staphylococcus aureus, and one case was Candida albicans. Therate of fluid comtamination was15%. But, there was no significant statisticaldifference between the two groups, P＞0.05. There was no visible differencebetween the two groups in the rate of fluid contamination.4The incidence of congestive heart failure: In the experimental group, thecongestive heart failure happened to one case. The rate was1%. In the controlgroup congestive heart failure happened to two case. The incidence rate was9.2%. But, there was no significant statistical difference between the twogroups, P＞0.05. There was no visible difference between the two groups inthe rate of congestive heart failure.5The incidence of blockage and dredging: There were105times drainage inthe experimental group, the blockage of the drainage tube happened to24times,23of them were dredged, the blockage rate was22.9%and thedredging rate was95.8%; there were109times drainage in the control group,the blockage of the drainage tube happened to39times,22of them weredredged, the blockage rate was35.8%and the dredging rate was56.4%. Therewere significant statistical difference between the two groups, P<0.05. Theexperimental group was obviously less than the control group in the blockagerate of the drainage tube, higher than the control group in the dredging rate ofthe drainage tube.6The effective rate of treatment: In the experimental group, there were4cases complete remission,8cases partial remission，the total cases were12,the effective rate was70.6%; In the control group, there were one casescomplete remission,13cases partial remission，the total cases were14, theeffective rate was82.4%. But, there was no significant statistical differencebetween the two groups, P>0.05. There was no visible difference between thetwo groups in the effective rate of treatment.7The operating time-consuming between the two groups：In the experimentalgroup, the range of operating time was (16±30.3) seconds, and the averagetime was (21.75±4.17)seconds; In the control group, the range of operating time was (160±355)seconds, and the average time was (227.94±59.72)seconds.There was significant statistical difference between the two groups, P<0.001.The experimental group was obviously lower than the control group.8A comparison of patients’ degree of satisfaction: In the experimental group17patients give a mark of9.76±0.44; In the control group,17patients give amark of6.65±0.93. There was significant statistical difference between thetwo groups, P<0.001. The experimental group was obviously higher than thecontrol group.Conclusion: During the process of draining the pericardial effusion, theconnective-tube’s dropping rate, the blockage rate, the incidence of air refluxand the operating time-consuming in the clinical operations are less than theConveen anti-reflux drainage bag; the dredging rate and the patientsatisfaction rate are higher than the Conveen anti-reflux drainage bag; Butthere were no obvious differences in the rate of fluid contamination andcongestive heart failure, and the effective rate of treatment.It is confirmed that disposable multifunctional drainage bag is a moresimple structure, easier to use, and more secure, and the same drainage effectof fluid drainage collection device.