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Objective@#To explore the clinical features of pneumoconiosis complicated with spontaneous pneumothorax to improve the diagnosis and treatment of this disease.@*Methods@#Analyze the clinical characteristics and treatment of 350 cases of pneumoconiosis complicated with spontaneous pneumothorax in Hunan Prevention and Treatment Institute for Occupational Diseases from May 2016 to May 2018.@*Results@#In 350 patients, 22 cases are pneumoconiosis stage I, accounting for 6.3%, 26 cases are pneumoconiosis stage Ⅱ, accounting for 7.4%, 302 cases were pneumoconiosis stage Ⅲ, accounting for 86.3%.168 cases were recurrent pneumothorax, the recurrence rate was as high as 48%.There were 232 cases occurred in winter and spring, accounting for 66.3%. Chronic obstructive pulmonary disease and pulmonary infection were 54.9% and 47.4%, respectively. 233 patients were treated with basic therapy such as high flow oxygen therapy, with an effective rate of 93.1%. 114 cases were treated with thoracic closed drainage, with an effective rate of 86%.@*Conclusion@#Spontaneous pneumothorax is a common complication of pneumoconiosis with high recurrence rate. According to the different conditions to give different treatments in a timely manner can achieve better results.
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BACKGROUND@#After general thoracic surgery, a chest tube is usually placed for closed drainage to expel gas accumulation in the thoracic cavity and fluid accumulation to promote lung re-expansion. It can also be observed whether there is active bleeding after the operation and whether there is a pulmonary leak. The conventional drainage of the chest cavity is connected with a water-sealed drainage bottle, and the patient condition is judged by observing the drainage situation and the fluctuation of the water column, which is a very classic method. However, the water-sealed bottle has the disadvantages of being easy to overturn and inconvenient to carry, which is not conducive to the early activities of patients. Under the concept of accelerated rehabilitation, our center applied a new type of anhydrous thorax negative pressure drainage device and achieved good results. The purpose of this study was to observe the effect of a new type of anhydrous thoracic negative pressure drainage device in patients after thoracic surgery.@*METHODS@#Retrospective analysis of patients who underwent lung surgery in the First Affiliated Hospital of Zhejiang University Medical College from January 2018 to December 2019, patients were divided into two groups. One group of patients used a traditional closed-chest drainage water-sealed bottle as a control group, and the other group used a new type of anhydrous negative-pressure drainage bottle as an experimental group. Patients' gender, age, hypertension, diabetes, smoking history, surgical incisions and surgical methods, and the length of hospital stay and postoperative hospital stay were calculated.@*RESULTS@#There were no statistical differences in age, gender, comorbidities (hypertension, diabetes, smoking history), scope of surgery, and duration of surgery between the two groups of patients, but there were statistical differences in surgical incisions between the two groups of patients (P=0.01). We found that patients using the new waterless negative pressure drainage device were shorter than patients with water negative pressure drainage device in terms of postoperative hospital stay and total hospitalization time, and the difference was statistically significant (P=0.02, P=0.04).@*CONCLUSIONS@#The new type of anhydrous thoracic negative pressure drainage device has a good effect on the rapid recovery and advancement after thoracic surgery.
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Objective@#To explore the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents.@*Methods@#From January 2010 to May 2018, 62 young patients with spontaneous pneumothorax treated in School Hospital of Zhejiang Ocean University and referral to superior hospital were selected.The patients were followed up by telephone or clinic for 24 months after discharge, and their general information and recurrence were collected.Logistic regression multivariate analysis was used to investigate the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents.@*Results@#Sixty-two patients were followed up, 15 patients with recurrence, and the recurrence rate was 24.19%.Univariate analysis showed that age over 20[recurrence and non-recurrence ≤20 years old 11 cases (73.33%), 11 cases (23.40%); >20 years old 4 cases (26.67%), 36 cases (76.59%)], body mass over 19.6kg/m2[recurrence and non-recurrence BMI ≤19.6 10 cases (66.67%), 18 cases (38.30%); BMI>19.6 5 cases (33.33%), 29 cases (61.70%)], smoking[recurrence and non-recurrence smoking 12 cases (80.00%), 14 cases (29.79%); non-smoking 3 cases (20.00%), 33 cases (70.21%)], degree of pneumobula lesions[recurrence and non-recurrence mildly 3 cases (20.00%), 19 cases (40.43%); medium 5 cases (33.33%), 20 cases (42.55%); severe 7 cases (46.67%), 8 cases (17.02%)], pneumothorax[recurrence and non-recurrence a little 2 cases (13.33%), 20 cases (46.81%); massive 13 cases (86.67%), 27 cases (53.19%)] and diameter of pneumobula over 1cm[recurrence and non-recurrence ≤1cm 5 cases (33.33%), 28 cases (61.70%); >1cm 10 cases (66.67%), 18 cases (38.29%)] were associated with recurrence after closed thoracic drainage (χ2=11.857, 5.192, 9.325, 13.522, 9.824, 6.823, all P<0.05). The results of logistic multivariate regression analysis showed that age(OR: 1.224; 95% CI: 0.958-12.142), BMI(OR: 3.463; 95% CI: 0.824-9.024), smoking(OR: 5.000; 95% CI: 1.534-9.852), degree of pneumobulus lesions(OR: 12.041; 95% CI: 6.032-12.174) and pneumothorax(OR: 2.465; 95% CI: 1.627-4.684) were the influencing factors for recurrence after primary spontaneous pneumothorax drainage in adolescents (all P<0.05).@*Conclusion@#Younger than 20 years of age, smoking, pneumobulous lesions and large pneumothorax are risk factors for recurrence after primary spontaneous pneumothorax drainage.
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Objective To explore the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents.Methods From January 2010 to May 2018,62 young patients with spontaneous pneumothorax treated in School Hospital of Zhejiang Ocean University and referral to superior hospital were selected . The patients were followed up by telephone or clinic for 24 months after discharge,and their general information and recurrence were collected.Logistic regression multivariate analysis was used to investigate the influencing factors of recurrent spontaneous pneumothorax after thoracic closed drainage in adolescents .Results Sixty－two patients were followed up,15 patients with recurrence,and the recurrence rate was 24.19%.Univariate analysis showed that age over 20[recurrence and non －recurrence ≤20 years old 11 cases (73.33%),11 cases (23.40%);＞20 years old 4 cases (26.67%),36 cases (76.59%)],body mass over 19.6kg／m2 [ recurrence and non －recurrence BMI ≤19.6 10 cases (66.67%),18 cases (38.30%);BMI＞19.6 5 cases (33.33%),29 cases (61.70%)],smoking [recurrence and non －recurrence smoking 12 cases ( 80.00%), 14 cases ( 29.79%); non －smoking 3 cases (20.00%),33 cases (70.21%)],degree of pneumobula lesions [recurrence and non －recurrence mildly 3 cases (20.00%),19 cases (40.43%);medium 5 cases (33.33%),20 cases (42.55%);severe 7 cases (46.67%), 8 cases ( 17.02%)], pneumothorax [ recurrence and non －recurrence a little 2 cases ( 13.33%), 20 cases (46.81%);massive 13 cases (86.67%),27 cases (53.19%)] and diameter of pneumobula over 1cm[ recurrence and non －recurrence ≤1cm 5 cases (33.33%),28 cases (61.70%);＞1cm 10 cases (66.67%),18 cases (38.29%)] were associated with recurrence after closed thoracic drainage (χ2 ＝11.857,5.192,9.325,13.522, 9.824,6.823,all P＜0.05).The results of logistic multivariate regression analysis showed that age (OR:1.224;95%CI:0.958－12.142),BMI(OR:3.463;95% CI:0.824－9.024),smoking(OR:5.000;95% CI:1.534－9.852), degree of pneumobulus lesions ( OR:12.041;95% CI:6.032 －12.174) and pneumothorax (OR:2.465;95% CI:1.627－4.684) were the influencing factors for recurrence after primary spontaneous pneumothorax drainage in adolescents (all P＜0.05).Conclusion Younger than 20 years of age,smoking,pneumobulous lesions and large pneumothorax are risk factors for recurrence after primary spontaneous pneumothorax drainage .
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Objective To explore the effect of pigtail and silicone catheters on thoracic close drainage. Methods Sixty-one patients undergoing closed thoracic drainage hospitalized in our department from June 2013 to November 2016 were divided into the control group (n=31) and observation group (n=30). The control group was treated with closed pleural drainage using silicone catheter and the observation group using pigtail catheter. The two groups were compared in respect of drainage effect nursed the same. Results The extubation time, wound healing time of the observation group were all significantly shorter than those of the control group ( P<0.05). The pain score, complication rate and hospitalization cost were all significantly lower as well ( P < 0.05). Conclusions The pigtail catheter is more effective in the treatment of pneumothorax. It can alleviate pains, reduce the complication rate and surgical scar, and improve patient's satisfaction.
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Objective To evaluate the effects of a self-designed multi-function anti-reflux drainage connector on preventing catheter-associated urinary infection in patients with long-term indwelling catheters.Methods A total of 100 elderly males with indwelling catheters from 10 nursing homes in our city were selected and randomly divided into the control group (n=50) and the experimental group (n=50) from January 2013 to December 2015.The patients in the control group were indwelled with Foley catheters and connected with an ordinary disposable drainage bags;the patients in the experimental group were indwelled the same catheters and connected to disposable drainage bags with an multi-function anti-reflux drainage connector.Patients' urine in catheters and drainage bags from two groups were collected for urine culture on 7th,14th,21st,28th days.The cases of catheter plugging on the 7th,14th,21st,28th days and the cases of catheter encrustation on 28th day in two groups were recorded.Results The cases of bacteriuria on the 7th,14th,21st,28th days in the experimental group were significantly less than those in the control group (P＜0.05),and were also significantly less than those in the drainage bags in the same group (P＜0.05).The cases of catheter plugging on the 7th,14th,21st,28th days were not significantly different between two groups(P＞0.05).The cases of catheter encrustation on the 28th day in the experimental group were significantly less than those in the control group (P＜0.05).Conclusion Multi-function anti-reflux drainage connector can safely and effectively prevent catheter-associated urinary infection,reducing bacteria ascending with reflux of urine as well as catheter encrustation.
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<p><b>OBJECTIVE</b>To study the clinical effects of negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis.</p><p><b>METHODS</b>From June 2013 to December 2016, there were 35 cases of chronic osteomyelitis patients in our department, including 23 males and 12 females, ranging in age from 11 to 65 years old, with an average of 34 years old. The course of disease ranged from 8 to 46 months, with an average of 26 months. All patients were chronic osteomyelitis caused by open wounds. The lesions had recurrent redness and swelling and purulent skin perforation. Thirty-two patients had positive results in bacterial culture of sinus secretions, and 3 patients had negative results. Imaging examination showed the lesions of bone destruction, bone defects, surrounded by bone hyperplasia sclerosis. At the first stage, complete debridement was performed to remove necrotic tissues and inflammatory tissues; and the dressing of negative pressure closed drainage was used to completely cover the wound so as to promote the repair of the wound. At the second stage, the vancomycin loaded, calcium sulfate and autogenous iliac cancellous bone were mixed into the bone graft complex to evenly fill the lesions. The healing of the wound was observed and X-ray examination of the lesion was carried out to observe the absorption of calcium sulfate and the growth of new bone.</p><p><b>RESULTS</b>Twenty-six patients underwent debridement and negative pressure closed drainage on time, 6 patients 2 times, and 3 patients 3 times. Thirty-two patients had incisions healed with grade A; 2 patients had incisions healed with grade B, and got completely healing after anti-infection, and wound dressing treatment; 1 patient had an incision healed with grade C, and got normal healing after re-debridement at the 4th week after operation. All patients did not have skin redness and ulceration again. X-ray imaging showed that the implanted calcium sulphate was absorbed gradually around 4 weeks, new bone was formed at 8 weeks, and bone defects in the lesions area were healed completely at 6 months to 2 years.</p><p><b>CONCLUSIONS</b>Negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis is a good and reliable method, worthy of clinical promotion.</p>
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Objective To explore the curative effect of the single pore video-assisted thoracoscopic surgery and thoracic closed drainage for patients with acute pyothorax by comparing the advantage and disadvantage of two methods.Methods The clinical data of 65 patients with acute pyothorax in our hospital from January 2012 to June 2015 were retrospectively analyzed.Of which 30 patients underwent single pore video-assisted thoracoscopic surgery were as observation group,35 cases received thoracic closed drainage were as the control group.The cura-tive effect of two methods for acute pyothorax was compared by analyzing the result data of two groups.Results The postoperative chest tube indwelling time,length of hospital stay,postoperative antibiotics of observation group were significantly less than those of the control group,the difference was statistically significant(P<0.05).And the incidence of postoperative complications,the proportion of the chronic pyothorax and secondary tube rate of observation group were lower than those of the control group,the difference was statistically significant(P<0.05). Conclusion The single pore video-assisted thoracoscopic surgery is safe and effective for treatment of acute pyothorax, which is worth promoting.
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Objective To explore the effect of the transcutaneous tracheostomy tube in patients with pneumothorax and its clinical value. Methods A prospective randomized controlled trial was conducted. Thirty-two patients with pneumothorax admitted to Department of Critical Care Medicine of Harrison International Peace Hospital of Hebei Medical University from June 2010 to June 2014 were enrolled. The patients were divided into control group and observation group,with 16 cases in each group. Beside the treatment for primary disease,the patients in control group received thoracic close drainage with traditional silica gel tube as performed by thoracic surgeons,and those in observation group received thoracic close drainage with transcutaneous tracheostomy tube by intensive care doctors. The curative effect and complications of the two groups were observed. Results Compared with control group,the time from diagnosis to operation(minutes:8.00±1.36 vs. 23.06±3.83,t=14.790,P=0.000)and the operation time were significantly shortened(days:5.37±1.02 vs. 7.31±1.70,t=7.286,P=0.000),the frequency of drainage tube replacement(times:0.18±0.40 vs. 3.87±1.14,t=12.128,P=0.000)and the times of repeated chest radiography(times:1.12±0.34 vs. 2.93±0.77,t=8.589,P=0.000)in observation group were significantly reduced,the length of hospital day was significantly shortened(days:8.30±1.37 vs. 24.56±5.62,t=17.289, P=0.000),the rates of dislocation of drainage tube(0 vs. 3 cases),obstruction of the tube(0 vs. 5 cases),and subcutaneous emphysema(3 vs. 16 cases)were reduced obviously,but there was no difference in incidence of incision infection(1 vs. 3 cases)and infection of thoracic cavity(0 vs. 2 cases). Conclusions The usage of transcutaneous tracheostomy tube in patients with pneumothorax is safe and simple. Doctors in ICU can independently do this procedure,and its effect is positive.
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Objective To investigate the effect of one-time anti reflux multi-function drainage bag in clinical application.Methods A total of 125 cases of benign prostate hyperplasis (BPH) were treated with transurethral resection of prostate (TURP) from October 2012 to March 2013 at our hospital of uropoiesis surgical department.All the cases were randomly divided into the control group (63 cases) and the experimental group(62 cases).The three cavities balloon catheter was connected with common drainage bag in the control group,and with one-time anti-reflux multi-function drainage bag in the experimental group.The urine in catheters and drainage bag of 3,5,7 days postoperatively in two groups was sampled for urine culture.The cases of daily urine tube plugging and daily drainage bag reflux in two groups were observed respectively.Results The cases of bacilluria significantly reduced in catheters of the experimental group compared with the control group and the drainage bag of the experimental group,respectively.The cases of bacilluria was significantly reduced in drainage bag compared with the control group.The cases of drainage bag reflux was significantly reduced compared with the control group.The cases of bacilluria in catheter and drainage bag had no significant difference in the control group.The cases of catheter plugging had no significant difference between two groups.Conclusions One-time anti reflux multi-function urine drainage bag can effectively prevent bacteria and reflux,and make the drainage system in a closed state.It has obvious advantage to prevent the happening of the retrograde infection compared with the common drainage bag.
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OBJECTIVE: To compare the clinical efficacy/significance and incidence of exposure to body fluids between the active closed drainage system and passive open drainage system in patients who underwent urologic surgeryMATERIALS AND METHODS: Patients who underwent elective and emergency open urologic surgery that required wound drainage were included. A daily data collection completed by the medical and the nursing staff was performed. Patients with dirty wounds were excludedRESULTS: Sixty-four patients were entered in the study. After exclusion, 56 patients [Group I (Passive drainage) = 27; Group 2 (Active drainage) = 29)] were evaluated for the performance of wound drainage systems. The drain-related complications of group 1 and group 2 were 26 percent and 10 percent, respectively [P 0.5 (NS)]. Change of dressing was more frequent in group 1 than in group 2 patients [P .000 (S)]. There were 567 (group 1CONCLUSION: The clinical efficacy of passive open drain and active closed drain systems were comparable. The risk of exposure of healthcare personnel to potentially harmful body fluids was less when closed suction drain was used in patients who underwent urologic surgery. (Author)
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Pyogenic liver abscess has been a life-threatening disease with a uniformly fatal outcome if left untreated. Changes in the etiology, clinical manifestations, methods of diagnosis, treatment and prognosis of pyogenic liver abscess have occurred slowly, but continuously, over the past century. Modern imaging techniques, improved drainage procedures, and appropriate antibiotic therapy have substantially reduced the mortality and the morbidity. A review of 103 patients with pyogenic liver abscess who were treated at Masan Samsung Hospital over a 5-year period from January 1992 to December 1996 was undertaken to characterize recent trends in diagnosis and management. There were 60 males and 43 females whose ages ranged from 11 to 85 years (mean 62.3 years). The peak age was in the 6th decade. Pyogenic liver abscess more often involved the right lobe (65.1%) than the left lobe (26.2%), and a single abscess was encountered more often than multiple abscesses in a 2.2:1 ratio. Upper abdominal pain, fever, and chills were the most common symptoms, and upper abdominal tenderness was the most common physical finding. An elevated serum alkaline phosphatase was seen in 73.8% of all patients and was the most common biochemical abnormality. Biliary tract disease was the most frequent underlying disorder. In the bacteriological study, we obtained positive cultures in 89.3% of the cases:65.0% were Gram-negative organism, 17.5% were Gram-positive organism, and 6.8% were anaerobes. E. coli was the most frequently cultured organism (31.5%). Ultrasonography and/or CT scanning was employed in the diagnosis and the follow up of all patients. Surgical open drainage was performed in 52 cases (50.5%) and percutaneous closed drainage in 51 cases (49.5%). The outcome of surgical open drainage was similar to that of percutaneous closed drainage, except for the mortality rate. Post-treatment complications occurred in 26 cases (25.2%), and the most frequent complication was a pulmonary problem (8.7%). The mortality rate due to pyogenic liver abscess was 7.8%, and the most common cause of death was sepsis.
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Female , Humans , Male , Abdominal Pain , Abscess , Alkaline Phosphatase , Biliary Tract Diseases , Cause of Death , Chills , Diagnosis , Drainage , Fatal Outcome , Fever , Follow-Up Studies , Liver Abscess, Pyogenic , Mortality , Prognosis , Sepsis , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The authors analyzed 103 cases of chronic subdural hematoma(SDH) treated in the department of Neurosurgery, Yonsei University Hospital from January 1976 to September 1983. All of the cases were operated on except a single case, which was treated conservatively. The results of the analysis are summarized as follows: 1) The chronic SDH occurred most frequently in the 5th decade, and 71.8% of the patients were older than their 4th decade. The chronic SDH were far more common in men(84.5%) than women(15.5%). 2) Seventy two patients(79.6%) had a history of previous head injury. Chronic alcoholism was noted in thirteen patients(12.6%). 3) Presenting symptoms and signs in decreasing order were headache(76.9%), motor weakness(44.7%), mental disturbance(43.7%), papilledema(42.7%), and vomiting(35%). 4) Brain CT scan was not only the most accurate diagnostic procedure but also important for planning operative intervention as well as evaluating the prognosis. Four patterns of CT densities were noted in chronic SDH;hypodense(43.3%), isodense(37.8%), hyperdense(13.5%), and mixed density(5.4%). Cerebral expansion rates decreased with age, which was less than 80% in patients over their 40s. The chronic SDH was found on the right side in 45.6% of cases and 41.8% on the left, while 12.6% of chronic SDH were bilateral. 5) Operative procedures in 102 cases, were as follows; 32 Simple burr hole closed drainage, 31 Simple burr hole open drainage, 31 craniotomy and membranectomy, and 10 craniectomy and membranectomy. In conclusion, simple burr hole closed system drainage is the most effective and the least invasive procedure for the treatment of chronic SDH. Membranectomy with craniotomy or craniectomy should be reserved for such cases as recollection of SDH, failure of brain expansion, solid hematoma, and extensive swelling of the white matter subjacent to the hematoma.
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Humans , Alcoholism , Brain , Craniocerebral Trauma , Craniotomy , Drainage , Hematoma , Hematoma, Subdural, Chronic , Neurosurgery , Prognosis , Surgical Procedures, Operative , Tomography, X-Ray ComputedABSTRACT
Cerebral paragonimiasis, occurring as an extrapulmonary infestation, is one of the important intracranial lesions in Korea. We have experienced a case of multiple huge brain abscesses caused by cerebral paragonimiasis. The patient, 17 year old boy, had chief complaints of headache and vomiting followed by mental deterioration. Neurologically, the patient presented mental change, papilledema, left abducense palsy and right hemiparesis. The treatment included the closed drainage followed by total removal of abscess capsules which was confirmed histopathologically. This paper is concerned with the description of the clinical features of cerebral paragonimiasis and review of literatures.