胸腔引流管置入治疗肝性胸水患者的结局。
Outcomes of patients with chest tube insertion for hepatic hydrothorax.
机构信息
Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
出版信息
Hepatol Int. 2009 Dec;3(4):582-6. doi: 10.1007/s12072-009-9136-z. Epub 2009 Aug 11.
PURPOSE
Case reports and small case series have reported a high rate of complications associated with chest tube placement for hepatic hydrothorax. We describe the in-hospital and 3-month outcomes of patients who have had this procedure.
METHODS
A retrospective medical record review was performed of all patients admitted to a tertiary care center over a 10-year period with a chest tube placed for hepatic hydrothorax. Demographic data and outcomes were collected and analyzed.
RESULTS
Seventeen patients were identified; 12 were taking diuretics and 8 were taking multiple diuretics at the time of admission. MELD score was 14 (range = 7-34). During hospitalization, 16 had at least 1 and 12 had more than 1 complications. The most common complications were acute kidney injury (n = 11), pneumothorax (n = 7), and empyema (n = 5). Two patients died during the index admission and four others within 3 months of that admission. Six of seven patients who received TIPS survived.
CONCLUSIONS
Chest tube insertion for hepatic hydrothorax carries significant morbidity and mortality, with questionable benefit.
目的
病例报告和小病例系列报告显示，与肝性胸水的胸腔引流管放置相关的并发症发生率很高。我们描述了接受该手术的患者的住院期间和 3 个月的结果。
方法
对在 10 年期间因肝性胸水而在三级护理中心住院并放置胸腔引流管的所有患者进行回顾性病历审查。收集并分析了人口统计学数据和结果。
结果
共确定了 17 名患者；入院时，12 名患者正在服用利尿剂，8 名患者正在服用多种利尿剂。MELD 评分 14 分（范围=7-34）。住院期间，16 名患者至少出现 1 种并发症，12 名患者出现多种并发症。最常见的并发症是急性肾损伤（n=11）、气胸（n=7）和脓胸（n=5）。2 名患者在指数住院期间死亡，另有 4 名患者在该住院后 3 个月内死亡。接受 TIPS 治疗的 7 名患者中有 6 名存活。
结论
肝性胸水的胸腔引流管插入术存在显著的发病率和死亡率，且疗效值得怀疑。
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