Mirmohammad-Sadeghi Mohsen, Pourazari Pejman, Akbari Mojtaba
Department of Cardiac Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
J Res Med Sci. 2017 Dec 26;22:134. doi: 10.4103/jrms.JRMS_739_17. eCollection 2017.
Chest tubes are used in every case of coronary artery bypass grafting (CABG) to evacuate shed blood from around the heart and lungs. This study was designed to assess the effective of Jackson-Pratt drain in compare with conventional chest drains after CABG.
This was a randomized controlled trial that conducted on 218 patients in Chamran hospital from February to December 2016. Eligible patients were randomized in a 1:1 ratio. Jackson-Pratt drain group had 109 patients who received a chest tube insertion in the pleural space of the left lung and a Jackson-Pratt drain in mediastinum, and Chest tube drainage group had 109 patients who received double chest tube insertion in the pleural space of the left lung and the mediastinum.
The incidence of pleural effusions in Jackson-Pratt drain group and chest tube group were not statistically different. The pain score at 2-h in Drain group was significantly higher than chest tube group ( = 0.001), but the trend of pain score between groups was not significantly different ( = 0.097). The frequency of tamponade and atrial fibrillation (AF) were significantly lower in Jackson-Pratt drain group ( < 0.05).
The Jackson-Pratt drain is equally effective for preventing cardiac tamponade, pleural effusions, and pain intensity in patients after CABG when compared with conventional chest tubes, but was significantly superior regarding efficacy to hospital and Intensive Care Unit length of stay and the incidence of AF.
在每例冠状动脉旁路移植术(CABG)中均使用胸管,以排出心脏和肺部周围的引流血。本研究旨在评估杰克逊-普拉特引流管与CABG术后传统胸管相比的有效性。
这是一项随机对照试验,于2016年2月至12月在查姆兰医院对218例患者进行。符合条件的患者按1:1比例随机分组。杰克逊-普拉特引流管组有109例患者,在左肺胸膜腔插入胸管并在纵隔放置杰克逊-普拉特引流管,胸管引流组有109例患者,在左肺胸膜腔和纵隔插入双胸管。
杰克逊-普拉特引流管组和胸管组胸腔积液的发生率无统计学差异。引流管组2小时时的疼痛评分显著高于胸管组(P = 0.001),但两组间疼痛评分趋势无显著差异(P = 0.097)。杰克逊-普拉特引流管组心包填塞和心房颤动(AF)的发生率显著更低(P < 0.05)。
与传统胸管相比,杰克逊-普拉特引流管在预防CABG术后患者的心包填塞、胸腔积液和疼痛强度方面同样有效,但在缩短住院时间和重症监护病房住院时间以及降低AF发生率方面疗效显著更优。