电视辅助胸腔镜手术治疗创伤性持续性气胸的前瞻性评估
A prospective evaluation of video-assisted thoracic surgery for persistent air leak due to trauma.
作者信息
Schermer C R, Matteson B D, Demarest G B, Albrecht R M, Davis V H
机构信息
Department of Surgery, University of New Mexico, Albuquerque, USA.
出版信息
Am J Surg. 1999 Jun;177(6):480-4. doi: 10.1016/s0002-9610(99)00100-2.
BACKGROUND
The time required for air leak resolution after chest trauma is not well described. Based on an institutional review of posttraumatic air leaks our hypothesis was that video-assisted thoracic surgery (VATS) for persistent posttraumatic air leak would decrease chest tube days and length of stay compared with nonoperative management.
METHODS
Patients were offered VATS versus nonoperative management when air leaks persisted longer than 3 days and the patients were otherwise ready for discharge. Chest tube days and length of stay were recorded.
RESULTS
Of 223 trauma patients requiring chest tubes, 50 had persistent air leaks, 39 of whom were otherwise ready for discharge. Twenty-five chose VATS and 14 nonoperative (NOP) treatment. The mean chest tube days was 8.1 for VATS versus 11.8 for NOP (P = 0.001). Mean length of stay was 9.7 days for VATS and 16.5 days for NOP (P = 0.002).
CONCLUSIONS
In patients otherwise ready for discharge VATS reduces chest tube days and length of stay when used to treat persistent posttraumatic air leak.
背景
胸部创伤后漏气消失所需时间尚无详尽描述。基于对创伤后漏气情况的一项机构性研究，我们的假设是，对于持续性创伤后漏气，与非手术治疗相比，电视辅助胸腔镜手术（VATS）可减少胸管留置天数和住院时间。
方法
当漏气持续超过3天且患者在其他方面已准备好出院时，为患者提供VATS或非手术治疗两种选择。记录胸管留置天数和住院时间。
结果
在223例需要留置胸管的创伤患者中，50例存在持续性漏气，其中39例在其他方面已准备好出院。25例选择VATS治疗，14例选择非手术（NOP）治疗。VATS组的平均胸管留置天数为8.1天，NOP组为11.8天（P = 0.001）。VATS组的平均住院时间为9.7天，NOP组为16.5天（P = 0.002）。
结论
对于在其他方面已准备好出院的患者，VATS用于治疗持续性创伤后漏气时可减少胸管留置天数和住院时间。
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