Kuester Jan R, Frese Steffen, Stein Robert M, Roth Thierry, Beshay Morris, Schmid Ralph A
Division of General Thoracic Surgery, University Hospital Berne, CH-3010 Berne, Switzerland.
Interact Cardiovasc Thorac Surg. 2006 Apr;5(2):139-44. doi: 10.1510/icvts.2005.122770. Epub 2006 Jan 13.
Few trials to guide clinical management of primary spontaneous pneumothorax (PSP) exist. This study aims to reveal current practice in the management of PSP in Switzerland, to define the level of consensus and to provide evidence in guiding clinical practice. Questionnaires were sent to 355 departments of internal medicine and surgery in Switzerland and 114 (32.1%) were available for analysis. Recommendations based on the highest consensus are extracted. Good to very good consensus is reached in 63% of all management options. There is very good consensus for the management of clinically stable or unstable patients with small or large PSP, for the treatment of patients without chest tubes and the operative management of persistent air leaks and recurrence prevention. There is good consensus concerning the role of suction, the size of chest tubes, and the use of CT-scans. However, there is little consensus concerning chest tube removal and chemical pleurodesis. Good and very good consensus exists for most management options in the treatment of PSP in Switzerland. The given recommendations can be used as evidence in guiding clinical practice in circumstances where no evidence of higher levels exists.
几乎没有试验可用于指导原发性自发性气胸（PSP）的临床管理。本研究旨在揭示瑞士PSP管理的当前实践，确定共识水平，并为指导临床实践提供证据。向瑞士的355个内科和外科科室发送了问卷，其中114个（32.1%）可供分析。提取了基于最高共识的建议。在所有管理选项中，63%达成了良好到非常好的共识。对于临床稳定或不稳定的小或大PSP患者的管理、无胸管患者的治疗以及持续性漏气的手术管理和复发预防，达成了非常好的共识。关于吸引的作用、胸管的尺寸和CT扫描的使用，达成了良好的共识。然而，关于胸管拔除和化学性胸膜固定术，几乎没有共识。在瑞士PSP治疗的大多数管理选项中存在良好和非常好的共识。在没有更高水平证据的情况下，给出的建议可作为指导临床实践的证据。
