Kejriwal Nand K, Newman Mark A J
Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
ANZ J Surg. 2005 Aug;75(8):710-2. doi: 10.1111/j.1445-2197.2005.03479.x.
It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site.
We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size 19-F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures.
Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1-12). The average postoperative length of stay was 7.6 days (range 3-44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove.
The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks.
在胸部手术后使用多个大口径半刚性胸管引流胸腔是标准做法。这些胸管会在插入部位引起疼痛和不适。
我们描述了在开胸术后使用单个小硅胶引流管的经验。2001年11月至2003年11月，我们机构对37例患者使用19F硅胶胸管（布雷克引流管）引流胸腔。患者年龄在18至81岁之间（平均65岁）。手术包括22例肺叶切除术、2例双肺叶切除术、10例楔形切除术和3例其他手术。
每位患者的总引流量在420至5440毫升之间（平均1387毫升）。引流管平均留置4.3天（范围1至12天）。术后平均住院时间为7.6天（范围3至44天，中位数5天）。3例患者分别因引流管移位、持续性漏气和支气管胸膜瘘需要额外插入一根引流管。这些并发症发生在本系列的前15例患者中。没有患者出现持续性胸腔积液。主观上，这些引流管对患者来说更舒适，且更容易拔除。
开胸术后使用单个小硅胶胸管引流液体和气体可能是安全有效的，尽管对于持续性漏气可能需要额外插入一根引流管。
