Knottenbelt J D, van der Spuy J W
Trauma Unit, Groote Schuur Hospital, Cape Town, South Africa.
Injury. 1990 Mar;21(2):77-80. doi: 10.1016/0020-1383(90)90058-3.
Tube thoracostomy is a well-established method for treating traumatic pneumothorax. Using a protocol based on the presence of air leakage and degree of expansion of the lung, it is possible in most cases to remove the drain within 24 h with minimal morbidity and excellent results. The early identification of patients needing operative or other intervention minimizes the hospital stay and complications associated with continued air leak. Experience using this protocol in a prospective series of 803 consecutive adult patients with traumatic pneumothorax is presented. A total of 300 patients (37.3 per cent) were successfully managed without drainage. Of the 504 patients drained, 333 (66.1 per cent) had the intercostal drain removed within 24 h. Mean hospital stay was 22 h for straightforward cases, and 49 h for those with a continuing leak. Ten patients required thoracotomy, a rate of 1.24 per cent. There were no deaths and no empyemata in our patients.
胸腔闭式引流术是治疗创伤性气胸的一种成熟方法。根据漏气情况和肺膨胀程度制定方案，在大多数情况下，可在24小时内拔除引流管，发病率极低且效果良好。早期识别需要手术或其他干预的患者可缩短住院时间，并减少与持续漏气相关的并发症。本文介绍了在803例连续的成年创伤性气胸患者中应用该方案的经验。共有300例患者（37.3%）未行引流即成功治愈。在504例行引流的患者中，333例（66.1%）在24小时内拔除了肋间引流管。单纯病例的平均住院时间为22小时，持续漏气的患者为49小时。10例患者需要开胸手术，发生率为1.24%。我们的患者中没有死亡病例，也没有发生脓胸。
