Kim H, Shyn P B, Wu L, Levesque V M, Khorasani R, Silverman S G
Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02115, USA.
Clin Radiol. 2017 Oct;72(10):898.e1-898.e5. doi: 10.1016/j.crad.2017.05.001. Epub 2017 May 26.
To compare the safety of evacuated bottle-assisted thoracentesis with wall suction-assisted thoracentesis.
An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study of 161 consecutive patients who underwent 191 evacuated bottle-assisted thoracenteses from 1 January 2012 to 30 September 2012, and 188 consecutive patients who underwent 230 wall suction-assisted thoracenteses from 1 January 2013 to 30 September 2013 was conducted. All procedures used imaging guidance. Primary diagnosis, age, gender, total fluid volume removed, and adverse events (AE) up to 30 days post-procedure were recorded and graded using Common Terminology Criteria for Adverse Events 4.0 (CTCAE).
Overall AE rates were 42.9% (82/191) for the evacuated bottle group and 19.6% (45/230) for the wall suction group (p<0.0001). Grade I AE occurred more commonly in the evacuated bottle group than in the wall suction group, [41.9% (80/191) and 18.3% (42/230)], respectively (p<0.0001). No significant differences were observed in grade 2 [0.5% (1/191) and 0% (0/230), p=0.45] or grade 3 AE [0.5% (1/191) and 1.3% (3/230), p=0.63] between the evacuated bottle and wall suction groups, respectively. No grade 4 or 5 AE occurred. Excluding transient chest pain and cough, there was no statistical difference in overall AE rate between the evacuated bottle and wall suction groups [11% (21/191) and 8.3% (19/230), p=0.4].
Image-guided thoracentesis performed with wall suction is safe when compared to evacuated bottles. The use of wall suction, in comparison to evacuated bottles, may decrease the incidence of transient chest pain or cough.
比较真空瓶辅助胸腔穿刺术与墙壁吸引辅助胸腔穿刺术的安全性。
进行了一项经机构审查委员会批准、符合《健康保险流通与责任法案》的回顾性研究，纳入了2012年1月1日至2012年9月30日期间连续161例接受191次真空瓶辅助胸腔穿刺术的患者，以及2013年1月1日至2013年9月30日期间连续188例接受230次墙壁吸引辅助胸腔穿刺术的患者。所有操作均采用影像引导。记录主要诊断、年龄、性别、抽出的总液体量以及术后30天内的不良事件（AE），并使用不良事件通用术语标准4.0（CTCAE）进行分级。
真空瓶组的总体AE发生率为42.9%（82/191），墙壁吸引组为19.6%（45/230）（p<0.0001）。I级AE在真空瓶组中比在墙壁吸引组中更常见，分别为41.9%（80/191）和18.3%（42/230）（p<0.0001）。在真空瓶组和墙壁吸引组之间，2级AE[0.5%（1/191）和0%（0/230），p=0.45]或3级AE[0.5%（1/191）和1.3%（3/230），p=0.63]均未观察到显著差异。未发生4级或5级AE。排除短暂胸痛和咳嗽后，真空瓶组和墙壁吸引组的总体AE发生率无统计学差异[11%（21/191）和8.3%（19/230），p=0.4]。
与真空瓶相比，墙壁吸引引导下的胸腔穿刺术是安全的。与真空瓶相比，使用墙壁吸引可能会降低短暂胸痛或咳嗽的发生率。
