Chetty Govind K, Battula Narrinder R, Govindaswamy Radhika, Elahi Maqsood M
Department of Cardiac Surgery, Northern General Hospital, University of Lahore, Sheffield, United Kingdom.
Heart Surg Forum. 2006;9(4):E731-4. doi: 10.1532/HSF98.20061040.
In our earlier report, we suggested the Bonanno catheter (a 14-gauge suprapubic catheter) as a less traumatic but equally effective alternative for drainage of a variety of fluid collections, including pleural effusion. This study aims to evaluate the efficacy of the Bonanno catheter compared with closed-tube thoracostomy in draining pleural effusion in 38 patients following routine cardiac surgery between 2003 and 2004. Twenty patients were managed using the Bonanno catheter and 18 were treated with standard tube thoracostomy. Data were collected retrospectively and statistical analysis was performed using the SPSS software. P < .05 was considered significant.
There were 20 (53%) male and 18 (47%) female patients with a mean age of 63.5 years (range, 31-83 years). Significant differences were observed with regards to the amount of lignocaine administered locally, intra-procedure pain score, post-procedure pain score after 15 minutes, and amount of analgesia used on a regular basis (P < .05 in each case). Statistically, significant differences were also noted during 2 to 3 weeks follow-up between the 2 groups with regards to pain score. In the the tube thoracostomy group, 22.2% developed infection of the procedure site, requiring antibiotic treatment, whereas no infection was reported in the Bonanno group (P < .001).
This study provided evidence that smallbore drains such as the Bonanno catheter are safe and better tolerated than standard chest drains. This is consistent with the British Thoracic Society guidelines that strongly recommend small-bore drains for the drainage of pleural effusions as they are more comfortable than larger-bore tubes.
在我们早期的报告中，我们提出博南诺导管（一种14号耻骨上导管）作为一种创伤较小但同样有效的替代方法，用于引流包括胸腔积液在内的各种液体聚集物。本研究旨在评估2003年至2004年期间38例常规心脏手术后患者使用博南诺导管与闭式胸腔引流术引流胸腔积液的疗效。20例患者使用博南诺导管进行治疗，18例患者接受标准胸腔闭式引流术治疗。数据进行回顾性收集，并使用SPSS软件进行统计分析。P <.05被认为具有统计学意义。
有20例（53%）男性和18例（47%）女性患者，平均年龄为63.5岁（范围为31 - 83岁）。在局部使用利多卡因的量、术中疼痛评分、术后15分钟疼痛评分以及常规使用的镇痛量方面观察到显著差异（每种情况P <.05）。统计学上，两组在2至3周随访期间的疼痛评分也存在显著差异。在胸腔闭式引流术组中，22.2%发生手术部位感染，需要抗生素治疗，而博南诺组未报告感染（P <.001）。
本研究提供的证据表明，博南诺导管等细孔引流管比标准胸腔引流管更安全且耐受性更好。这与英国胸科学会指南一致，该指南强烈推荐使用细孔引流管引流胸腔积液，因为它们比大口径引流管更舒适。
