Programa de Pós-Graduação Do Instituto de Assistência Médica Ao Servidor Público Estadual (IAMSPE), Av. Ibirapuera, 981 - 2º andar, Vila Clementino, São Paulo, SP, 04029-000, Brazil.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):973-979. doi: 10.1007/s00068-020-01554-3. Epub 2020 Nov 26.
Tube thoracostomy (TT) is a simple and a life-saving procedure; nevertheless, it carries morbidity, even after its removal. Currently, TT is managed and removed by chest X-ray (CXR) evaluation. There are limitations and these are directly linked to complications. The use of thoracic ultrasound (US) has already been established in the diagnosis of pneumothorax (PTX) and hemothorax (HTX); its use, in substitution of CXR can lead to improvement in care. Our aim is to evaluate the efficiency and safety of US in the management of TT.
Prospective and randomized study with patients requiring TT. They were divided in groups according to their thoracic injuries (PTX and HTX) and randomized into two groups according to TT management: US and CXR. Data collected included gender, age, mechanism of injury, days to TT removal, complications after TT removal and presence of mechanical ventilation.
Sixty-one patients were randomized, of which 68.8% were male. The most frequent diagnosis was PTX, present in 37 cases. Median time for TT removal was 2.5 days in the US group and 4.9 in the control group (p = 0.009). The complication rate was 6.6%, with no morbidity in the US group. TT removal in patients with mechanical ventilation did not increase the incidence of complications.
The use of US in the management is efficient and safe. It allows early TT removal regardless the cause of the thoracic injury.
胸腔引流管（TT）是一种简单且能救命的程序；然而，即使在移除后，它仍会带来并发症。目前，TT 的管理和移除是通过胸部 X 光（CXR）评估来进行的。这种方法存在局限性，且这些局限性与并发症直接相关。胸腔超声（US）在气胸（PTX）和血胸（HTX）的诊断中已经得到了应用；用其替代 CXR 可以改善护理效果。我们旨在评估 US 在 TT 管理中的效率和安全性。
这是一项前瞻性、随机研究，纳入了需要 TT 的患者。根据他们的胸部损伤（PTX 和 HTX）将他们分为两组，并根据 TT 管理随机分为 US 组和 CXR 组。收集的数据包括性别、年龄、损伤机制、TT 移除天数、TT 移除后并发症以及是否存在机械通气。
共有 61 名患者被随机分组，其中 68.8%为男性。最常见的诊断是 PTX，共 37 例。US 组 TT 移除的中位数时间为 2.5 天，而对照组为 4.9 天（p = 0.009）。并发症发生率为 6.6%，US 组无一例发生并发症。有机械通气的患者进行 TT 移除并未增加并发症的发生率。
US 在 TT 管理中的应用是有效且安全的。无论胸部损伤的原因是什么，它都能更早地移除 TT。
