前瞻性随机试验：高负压吸引与低负压吸引在治疗转移性甲状腺癌颈清扫术后乳糜瘘中的应用。
Prospective randomized trial of high versus low negative pressure suction in management of chyle fistula after neck dissection for metastatic thyroid carcinoma.
机构信息
Department of Thyroid Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Head Neck. 2012 Dec;34(12):1711-5. doi: 10.1002/hed.21979. Epub 2011 Dec 16.
BACKGROUND
Negative pressure drainage has been shown to be an effective treatment of chyle fistula. However, the optimal level of negative pressure has not been determined. We therefore conducted a prospective randomized trial to address this issue.
METHODS
In all, 21 patients with chyle fistula were randomly assigned to a high negative pressure suction (HNPS) group (-600 mmHg, n = 10) or low negative pressure suction (LNPS) group (-125 mmHg, n = 11). The duration of drain leakage and hospital stay, and the incidence of complications were compared between the 2 groups.
RESULTS
All patients were successfully treated with conservative management without surgical intervention. The median durations of chyle leakage and hospital stay were significantly shorter in the HNPS group compared with the LNPS group: 4 versus 7 days (p = .0048) and 5 versus 11 days (p = .0107), respectively.
CONCLUSIONS
Negative suction was demonstrated to be highly effective in the management of chyle fistula, and HNPS appeared to be more efficient than LNPS.
背景
负压引流已被证实是治疗乳糜瘘的有效方法。然而，负压的最佳水平尚未确定。因此，我们进行了一项前瞻性随机试验来解决这个问题。
方法
共有 21 例乳糜瘘患者被随机分为高负压吸引（HNPS）组（-600mmHg，n=10）或低负压吸引（LNPS）组（-125mmHg，n=11）。比较两组患者引流漏出时间、住院时间和并发症发生率。
结果
所有患者均成功接受保守治疗，无需手术干预。与 LNPS 组相比，HNPS 组乳糜漏出时间和住院时间明显更短：4 天比 7 天（p=0.0048）和 5 天比 11 天（p=0.0107）。
结论
负压吸引在乳糜瘘的治疗中效果显著，高负压吸引比低负压吸引更有效。
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