The Effectiveness Of Closed Thoracic Drainage With Large-bore Or Small-bore Chest Tube On Patients With Primary Spontaneous Tension Pneumothorax

Objective:To investigate the effectiveness of closed thoracic drainage with large-or small-borechest tube on patients with primary spontaneous tension pneumothorax (PSTP)．Method:68PSTP patients were randomly assigned to small-bore chest tube group (STG)orlarge-bore chest tube group(LTG) prospectively，the underwater seal drainage treatmentwas applied to patients using24Fr chest tube with needle or central venous catheteraccordingly．Observing the days required for pulmonary reexpansion，chest tube retention，length of stay，and the success rate of treatment of the two groups to evaluate curativeeffect，Recording and comparing the complications of the occurrence of hemorrhagicpleural effusions， subcutaneous/mediastinal emphysema， infection， reexpansionpulmonary edema etc，as well as the conditions of tube plugging/detaching andre-catheterization in two groups．Results:The time required for pulmonary reexpansion，chest tube retention and hospitalizationdays in LTG and STG were respectively (4.4±2.1) VS (8.7±3.0)，(8.5±3.4) VS (11.3±5.6)，(10.2±4.1) VS (14.1±5.7) days，The times of LTG were shorter than those of STG（P＜0.001、0.05、0.01）. Treatment success rates of LTG and STG were90.9%VS65.7%，LTG’s is higher than STG (P <0.05)．The occurrence rates of subcutaneous/mediastinal emphysema and tube plugging/detaching in LTG and STG were27.3%VS65.7%、3.0%VS28.6%．Both rates of LTG were significantly lower than those in STG (P<0.005)，But the incidence of hemorrhagic pleural effusions in LTG was higher than that of STG(36.4%VS14.3%，P <0.05)．Conclusion:24Fr chest tube with needle is better than central venous catheter in the underwaterseal drainage treatment for PSTP patients， with a more reliable and safer clinicalapplication．...