The Clinical Trials Of Closed Thoracic Drainage Into Different Intercostals In The Treatment Of Spontaneous Pneumothorax

Objective To discuss the methods and the curative effect of differentintercostal closed thoracic drainage in the treatment of spontaneouspneumothorax,and to seek the methods of reduce postoperative complications.Methods From March,2010to March,2013,110patients with spontaneouspneumothorax were enrolled in the study. The patients were received closed thoracicdrainage in the department thoracic surgical of ChenZhou No.1People’s hospital inHunan province. All the patients enrolled were divided into the control group and thestudy group randomly，with55patients in each group.110patients underwent chestCT examination showed pneumothorax greater than40%.The patients in the controlgroup were treated with closed thoracic drainage at the second intercostal ofmidclavicular line. The patients in the study group were treated at third intercostalspace of anterior axillary line.Comparative analysis with operation time, the amountof anesthetics drug, postoperative drainage tube placement time, postoperative healingand prognosis, hospitalization time and the complications(postoperative pain score,drainage tube off the incision, subcutaneous emphysema, chest infection)postoperative serum myoglobin (Myo), upper limb activity after surgery,postoperative wound satisfaction between the two grouos were performed.Result1. The control group and study group in age, gender, body mass index and theextent of pneumothorax was no significant difference (P>0.05).2. The control group and study group patients were treated with closed thoracicdrainage successfully, operation time and lidocaine hydrochloride injection of thecontrol group were significantly higher than the study group, the difference wasstatistically significant (P <0.05).3. In the control group45cases were cured,in the study group47cases were cured.The study group compared with the control group, the cure rate is slightly better,but the two groups in the cure rate,transit rate,drainage tube placement time andhospitalization time was not statistically significant (P>0.05).4. After closed thoracic drainage,the control group and the study group patientswere given pain scores at6,12,24hour. Scores of the control group at each time pointwas higher than the study group, the difference was statistically significant(P<0.05).After closed thoracic drainage，tramadol hydrochloride tablets of the control groupwas higher than the study group,the difference was statistically significant (P <0.05).Subgroups of gender，pain scores and tramadol hydrochloride tablets was notstatistically significant (P>0.05), the comparison between groups,the same sex weresignificantly different (P <0.05).5. The cases of drainage tube off the incision and subcutaneous emphysemawhich occurred in the control group were higher than the study group, the differencewas statistically significant (P <0.05); postoperative chest infections was notstatistically significant (P>0.05).6. After closed thoracic drainage,the myoglobin was detected at6,12and24hours.At6hours,the study group was significantly lower than the control group, therewas statistically significant (P <0.05);at12and24hours were not statisticallysignificant(P>0.05).In the study group,ROM of shoulder was greater than the controlgroup, there was statistically significant (P <0.05). Postoperative wound satisfactionin the study group was higher than the control group, there was statistically significant(P <0.05).Conclusion1. The cure rate in the study group is slightly better than the control group;operation time and anesthetics were lower than the control group, it is safe andeffective.2. Postoperative complications occurred in the study group were significantlylower than the control group.After surgery ROM of shoulder and wound satisfactionin the study group were higher than the control group, it is worthy of further promotion.