Baringer Kristina, Talbert Steve
Division of Cardiothoracic Surgery, Florida Hospital, University of Central Florida, Orlando, FL, USA.
UCF College of Nursing, University of Central Florida, Orlando, FL, USA.
J Thorac Dis. 2017 Dec;9(12):5399-5403. doi: 10.21037/jtd.2017.11.15.
Air leaks after a pulmonary resection continue to be the most common postoperative complication. The presence of an air leak occurs in approximately 30-50% of patients immediately after surgery. Prolonged air leaks (PALs) predict an increased hospital length of stay, additional chest tube days and increased pain. The two types of systems used after surgery are digital and traditional chest drainage devices. Eighteen articles from four databases were evaluated for this analysis in chest drainage systems and managing air leaks after thoracic surgery. The digital and traditional drainage devices were evaluated. PALs were examined with interobserver variability of air leak assessment and differences in the two systems were addressed. The research gaps in the digital system are examining what flow thresholds should be used to safely remove a chest tube after surgery and for what length of time. In future research, the next step is standardizing chest tube management to decrease individual surgeon preference. Treatment of air leaks implementing scientific data instead of personal preference and opinion by a surgeon can lead to earlier chest tube removal, decreased morbidity and a shorter hospital stay.
肺切除术后的漏气仍然是最常见的术后并发症。术后立即有大约30%-50%的患者会出现漏气。持续性漏气（PALs）预示着住院时间延长、额外的胸管留置天数增加以及疼痛加剧。术后使用的两种系统是数字式和传统胸腔引流装置。从四个数据库中筛选出18篇文章用于本次胸腔引流系统及胸外科手术后处理漏气的分析。对数字式和传统引流装置进行了评估。通过漏气评估的观察者间变异性对持续性漏气进行了检查，并探讨了两种系统之间的差异。数字系统的研究空白在于确定术后安全拔除胸管应使用的流量阈值以及持续时间。在未来的研究中，下一步是规范胸管管理以减少个体外科医生的偏好。通过科学数据而非外科医生的个人偏好和意见来处理漏气，可实现更早拔除胸管、降低发病率并缩短住院时间。
