Wei Yi-Hsuan, Lee Cheng-Han, Cheng Hsiao-Neng, Tsao Lon-Ten, Hsiao Chien-Chou
Division of Neonatology, Department of Pediatric, Changhua Christian Hospital, Changhua, Taiwan.
Division of Neonatology, Department of Pediatric, Changhua Christian Hospital, Changhua, Taiwan; Medical College of Chung Shan Medical University, Taichung, Taiwan.
Pediatr Neonatol. 2014 Oct;55(5):376-80. doi: 10.1016/j.pedneo.2014.01.002. Epub 2014 Mar 19.
Pneumothorax is more frequent in the neonatal period, especially among premature infants. Pigtail catheters have been shown to be as effective as and less invasive than traditional chest tubes in adults; however, data regarding premature infants are limited. We aimed to compare the efficacy, safety, and complications associated with the placement of traditional chest tubes versus pigtail catheters in premature infants with pneumothoraces.
We retrospectively reviewed the medical records of premature infants with pneumothorax seen in the neonatal intensive care unit of a single medical center over a period of 11 years, who were treated with either traditional chest tubes or pigtail catheters. Changes in the vital signs before and after the procedures were recorded in both groups. Data on age, sex, clinical presentation, procedure time, subsequent therapies, hospital days to discharge, success rate, and complications of the procedures were collected from medical records and compared between the two methods of intervention.
Eighty-six thoracostomies, including 60 pigtail catheters and 26 traditional chest tubes, were performed in 66 premature infants. The success rate, demographics, days of tube insertion, length of hospital stay, days of mechanical ventilation, type of oxygen supply, and insertion-related complications were not significantly different between the two groups. Pigtail catheter insertion required a shorter procedure time than the traditional chest tube insertion (14.92 minutes vs. 25.31 minutes, respectively, p < 0.001).
Pigtail catheters are a safe and effective alternative to traditional chest tubes for premature infants receiving treatment for pneumothoraces in a neonatal intensive care unit. Placement of pigtail catheters is an easy and quick bedside procedure and is particularly useful for premature infants who require immediate air drainage.
气胸在新生儿期更为常见,尤其是在早产儿中。猪尾导管已被证明在成人中与传统胸管一样有效且侵入性更小;然而,关于早产儿的数据有限。我们旨在比较传统胸管与猪尾导管置入术在早产儿气胸治疗中的疗效、安全性及并发症。
我们回顾性分析了一家医疗中心新生儿重症监护病房11年间收治的接受传统胸管或猪尾导管治疗的气胸早产儿的病历。记录两组患儿手术前后生命体征的变化。从病历中收集年龄、性别、临床表现、手术时间、后续治疗、出院住院天数、成功率及手术并发症等数据,并对两种干预方法进行比较。
66例早产儿共进行了86次胸廓切开术,其中60例置入猪尾导管,26例置入传统胸管。两组在成功率、人口统计学特征、置管天数、住院时间、机械通气天数、供氧类型及置管相关并发症方面无显著差异。猪尾导管置入术所需手术时间比传统胸管置入术短(分别为14.92分钟和25.31分钟,p<0.001)。
对于新生儿重症监护病房中接受气胸治疗的早产儿,猪尾导管是传统胸管的一种安全有效的替代方法。猪尾导管置入术是一种简便快捷的床边操作,对需要立即排气的早产儿尤为有用。