Outcome of spontaneous and iatrogenic pneumothoraces managed with small-bore chest tubes
Outcome of spontaneous and iatrogenic pneumothoraces managed with small-bore chest tubes
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DOI：
10.1111/j.1399-6576.2011.02602.x
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发表时间：
2012-04-01
影响因子：
2.1
通讯作者：
Guidet, B.
中科院分区：
文献类型：
--
作者：
Galbois, A.;Zorzi, L.;Guidet, B.
背景：小口径胸管治疗医源性气胸的疗效知之甚少。本研究的目的是评估需要使用小口径胸管引流的医源性气胸的结局，并将结果与在同一单位使用相同器械治疗的自发性气胸进行比较。主要结果是需要的电视胸腔镜手术引流失败;次要结果是引流长度和插入胸tubes.Methods：气胸患者承认1997年和2007年之间的数量进行了回顾性研究。排除创伤性气胸和机械通气下发生的气胸。所有气胸引流使用相同的小口径胸管（8法国）根据我们的本地protocol.Results：五百六十一气胸进行了分析，431（76.8%）自发气胸和130（23.2%）医源性。医源性气胸与因引流失败而需要较少的电视辅助胸腔镜手术相关[校正比值比= 0.24（0.04，0.86）]。医源性气胸的引流时间长于原发性自发性气胸（3.8 +/- 3.1 vs. 2.7 +/- 1.8天，P < 0.001），短于继发性自发性气胸（4.6 +/- 2.3天，P = 0.004）。根据气胸的病因学，每例患者插入胸管的数量没有显著差异。结论：小口径胸管用于治疗医源性气胸是可行的，与用于自发性气胸相比，具有更好的成功率和稍长的引流时间。
Background: Little is known about the efficacy of management of iatrogenic pneumothoraces with small-bore chest tubes. The aim of this study was to assess the outcome of iatrogenic pneumothoraces requiring drainage managed with a small-bore chest tube and to compare the results to spontaneous pneumothoraces treated in the same unit with the same device. The primary outcome was requirement of video-assisted thoracoscopic surgery for drainage failure; secondary outcomes were length of drainage and number of inserted chest tubes.Methods: Patients with pneumothorax admitted between 1997 and 2007 were retrospectively identified. Traumatic pneumothoraces and those occurring under mechanical ventilation were excluded. All pneumothoraces were drained using the same small-bore chest tube (8 French) according to our local protocol.Results: Five hundred sixty-one pneumothoraces were analysed, 431 (76.8%) were spontaneous pneumothoraces and 130 (23.2%) were iatrogenic. Iatrogenic pneumothoraces were associated with less requirement of video-assisted thoracoscopic surgery for drainage failure [adjusted odds ratio= 0.24 ( 0.04, 0.86)]. Length of drainage of iatrogenic pneumothoraces was longer than for primary spontaneous pneumothoraces ( 3.8 +/- 3.1 vs. 2.7 +/- 1.8 days, P < 0.001) and shorter than for secondary spontaneous pneumothoraces ( 4.6 +/- 2.3 days, P = 0.004). Number of inserted chest tubes per patient was not significantly different according to pneumothoraces' aetiology.Conclusion: Small- bore chest tubes are feasible for treatment of iatrogenic pneumothoraces and have a better rate of success and slightly longer drainage duration than when used for spontaneous pneumothoraces.