Application Of Closed Thoracic Drainage With Central Venous Catheter Drainage In Pneumothorax Of Preterm Infants

Objective:Through Comparing the clinical efficacy of closed thoracic drainage with central venous catheter and traditional silicone tube in the treatment of pneumothorax in preterm infants and their effect on inflammatory mediators,the pros and cons of two tube types of closed thoracic drainage were explored in treatment.Methods:A retrospective study was conducted on 56 cases of pneumothorax in preterm infants admitted to Jiujiang Maternal and Child Health Care Hospital from January 2017 to January 2019.Among them,22 cases of closed thoracic drainage with central venous catheter were set as the experimental group,while 34 cases of closed thoracic drainage with traditional silicone tube drainage were set as the control group.the two-day lung recruitment rate,extubation time,ventilator weaning days,hospitalization time,complications were compared between the two groups.Meanwhile,Partial pressure of oxygen(PaO2)and Partial pressure of carbon dioxide(PaCO2)in blood gas analysis before and after treatment were compared to observe the recovery of respiratory function of the two groups.In addition,Procalcitonin(PCT),C-reactive protein(CRP)and Interleukin-6(IL-6)before and after treatment in the two groups were compared to observe the postoperative systemic inflammatory response of the two groups.Results:1.In the general data,there was no significant difference in gender,age and weight between the experimental group and the control group(P>0.05).2.In terms of clinical efficacy,in the experimental group,the two-day lung recruitment rate was 63.64%,the average extubation time was 5.18±1.74 days,and the average ventilator weaning days was 4.55±1.18 days;while in the control group,the two-day lung recruitment rate was 70.59%,the average extubation time was 5.35±1.81 days,and the average ventilator weaning days was 4.79±1.41 days.There was no significant difference in the two-day lung recruitment rate,extubation time and ventilator weaning days between the two groups(P>0.05).3.In the comparison of postoperative complications,22 cases were cured by closed thoracic drainage in the experimental group and 34 cases were cured by closed thoracic drainage in the control group.There were 17 cases(30.36%)of complications in the two groups,including 5 cases(22.73%)in the experimental group and 12 cases(35.29%)in the control group.With regard to hospitalization time,the average hospitalization time in the experimental group was 8.68±2.52 days,while the average hospitalization time in the control group was 13.56±3.83 days.There were significant differences in postoperative complications and hospitalization between the two groups(P<0.05).4.In terms of blood gas analysis in the experimental group,the mean values of PaO2 were 33.82±7.52 mmHg before surgery and 65.09±9.86 mmHg at 3 hours after surgery.The mean values of PaCO2 group were 56.18±8.52 mmHg before surgery and 39.9±4.86 mmHg at 3 hours after surgery.In terms of blood gas analysis in the control group,the mean values of PaO2 were 34.88±8.77 mmHg before surgery and 65.88±8.83 mmHg at 3 hours after surgery.The mean values of PaCO2 group were 55.18±9.72 mmHg before surgery and 39.4±4.37 mmHg at 3 hours after surgery.In terms of PaO2 or PaCO2,there was no significant difference between the two groups before surgery and 3 hours after surgery(P>0.05).5.In the comparison of inflammatory mediators,the levels of PCT,CRP and IL-6 in the experimental group on the first day,the second day and the third day after surgery were statistically different from those before surgery(P<0.05),and the overall trend was downward.Meanwhile,the levels of PCT,CRP and IL-6 in the control group increased on the first day after surgery,and the difference was statistically significant(P<0.05).There was a decrease on the second day after surgery,but it was still higher than the preoperative level,and the difference was statistically significant(P<0.05).On the third day after surgery,it returned to normal level,even slightly decreased,and the difference was not statistically significant(P>0.05).Conclusion:1.The clinical efficacy was the same in both two groups,but the incidence of postoperative complications in the experimental group was lower than those in the control group,and the average hospitalization time in the experimental group was shorter than those in the control group.Therefore,the closed thoracic drainage with central venous catheter used in the experimental group was convenient,safe,effective,and has clinical advantages.2.The degree and the duration of inflammatory reaction after surgery in the experimental group were significantly lower than those in the control group,and the internal condition of the body in the experimental group was more stable than that of the control group.Therefore,the closed thoracic drainage with central venous catheter in the experimental group was more conducive to the rapid recovery of children body function,and it was worthy of clinical application.