Management and recurrence of spontaneous pneumothorax in children
Management and recurrence of spontaneous pneumothorax in children
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DOI：
10.1093/pch/pxz032
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发表时间：
2020-03-01
影响因子：
1.9
通讯作者：
Gravel, Jocelyn
中科院分区：
文献类型：
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作者：
MEng, Martin Gariepy;Beaunoyer, Mona;Gravel, Jocelyn
目的：没有指南明确规定儿童自发性气胸的治疗方法。本研究的目的是评估实践中的变化，在儿童自发性气胸的管理和复发的概率。方法：本研究是一个回顾性的图表审查，然后通过电话随访，其中包括所有儿童谁访问了三级保健儿科医院自发性气胸的第一次发作之间2008年和2017年。主要结局是气胸的处理（观察、吸氧、针吸、肋间胸管、手术）和复发概率。所有图表均由评估者使用标准化报告表进行评估，10%的图表一式两份进行评估。通过电话联系所有儿童/家庭，以评估复发情况。主要分析的每种治疗方式和复发的比例，分别。结果：在研究期间，76名儿童被认为有资格参加这项研究。其中59例为原发性自发性气胸，17例为继发性自发性气胸。最常见的第一治疗方法是胸管插入（31），氧气（27）和观察（14）。共有54例患者可用于随访，其中28例复发（总队列的37%或52%的可用儿童）。结论：胸管插入是约40%的儿童首次自发性气胸的第一线治疗。在这一人群中，复发概率在37%至52%之间，大多数发生在接下来的几个月内。
Objective: No guideline clearly prescribes an approach to management of spontaneous pneumothorax in children. The objectives of this study were to evaluate practice variation in the management of spontaneous pneumothorax in children and its probability of recurrence.Methods: This study was a retrospective chart review followed by a phone follow-up that included all children who had visited a tertiary care paediatric hospital for a first episode of spontaneous pneumothorax between 2008 and 2017. The primary outcomes were the management of pneumothorax (observation, oxygen, needle aspiration, intercostal chest tube, surgery) and the probability of recurrence. All charts were evaluated by a rater using a standardized report form and 10% of the charts were evaluated in duplicate. All children/families were contacted by phone to assess recurrence. The primary analyses were the proportions of each treatment modalities and recurrence, respectively.Results: During the study period, 76 children were deemed eligible for the study. Among them, 59 had a primary spontaneous pneumothorax while 17 were secondary. The most common first therapeutic approaches were chest tube insertion (31), oxygen alone (27), and observation (14). A total of 54 patients were available for follow-up among whom a recurrence was observed in 28 (37% of the total cohort or 52% of available children).Conclusion: Chest tube insertion was the first line of treatment in about 40% of children with a first spontaneous pneumothorax. In this population, the recurrence probability is established between 37 and 52% and the majority occurs in the following months.