Effect of intrathoracic infusion of erythromycin by pig tail catheter in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax / 中国综合临床

ABSTRACT

Objective:To observe the effect of injecting erythromycin into chest cavity through pig tail celiac drainage catheter in the treatment of senile chronic obstructive pulmonary disease with spontaneous pneumothorax.Methods:From January 2015 to August 2018, 55 patients with chronic obstructive pulmonary disease admitted to thoracic surgery of the First People′s Hospital of Hefei, Anhui Province were analyzed retrospectively.All of them were old men who had spontaneous pneumothorax for many times or for the first time.They were divided into two groups by simple randomized method(control group and observation group). The observation group was treated by intrathoracic injection of erythromycin through the abdominal drainage tube of pig tail, while the control group was treated by intrathoracic injection of erythromycin through the conventional closed thoracic drainage tube.There were 23 cases in the observation group and 32 cases in the control group.The time of injecting erythromycin (once a day) into the chest cavity through different drainage tubes, the effect of perfusion, the time from clamping to extubation, the incidence of complications, the total effective rate of perfusion and the recurrence rate within 6 months after discharge were compared between the two groups.Results:The infusion time of erythromycin infusion and extubation in the observation group were (3.00±0.32) d and (2.41±0.24) d, which were shorter than those in the control group (4.22±0.39) d and (3.39±0.37) d, respectively, and the differences were statistically significant (t values were 2.298 and 2.218, respectively; P values were 0.026, 0.032, respectively.The incidence of chest pain in the observation group was 17.4%(4/23), lower than that in the control group 46.9% (15/32), the difference was statistically significant ( P=0.023). There was no serious complication of shock and death in the observation group, 1 case in the control group; 22 cases patients in the observation group and 23 cases patients in the control group were discharged from the hospital after extubation, respectively.The total effective rate, recurrence rate and cure rate of the observation group and the control group were 95.7%(22/23) and 71.9%(23/32), 34.8%(8/23) and 59.4%(19/32), 65.2%(15/23) and 37.5%(12/32), respectively.There was statistical significance (χ 2 values were 5.086, 1.816 and 4.114, respectively, all P<0.05). The observation group was superior to the control group in efficacy and recurrence rate. Conclusion:The treatment of chronic obstructive pulmonary disease in the elderly with spontaneous pneumothorax by intrathoracic infusion of erythromycin through the pig tail peritoneal drainage catheter has the advantages of short perfusion time, rapid extubation, low recurrence rate, low complication rate, good tolerance and good perfusion effect.