Division of General Thoracic Surgery, Department of Surgery, University of California, Davis Health, Sacramento.
JAMA Surg. 2022 Mar 1;157(3):269-274. doi: 10.1001/jamasurg.2021.7050.
Thoracostomy, or chest tube placement, is used in a variety of clinical indications and can be lifesaving in certain circumstances. There have been developments and modifications to thoracostomy tubes, or chest tubes, over time, but they continue to be a staple in the thoracic surgeon's toolbox as well as adjacent specialties in medicine. This review will provide the nonexpert clinician a comprehensive understanding of the types of chest tubes, indications for their effective use, and key management details for ideal patient outcomes.
This review describes the types of chest tubes, indications for use, techniques for placement, common anatomical landmarks that are encountered with placement and management, and an overview of complications that may arise with tube thoracostomy. In addition, the future direction of chest tubes is explored, as well as the management of chest tubes during the COVID-19 pandemic.
Chest tube management is subjective, but the compilation of data can inform best practices and safe application to successfully manage the pleural space and ameliorate acquired pleural space disease.
胸腔切开术，或胸管放置术，用于多种临床指征，在某些情况下可救命。随着时间的推移，胸腔切开术管或胸管不断发展和改进，但它们仍然是胸外科医生工具箱以及医学相邻专业的重要工具。这篇综述将为非专家临床医生提供全面了解各种类型的胸管、有效使用的适应证以及实现理想患者结局的关键管理细节。
本文综述描述了胸管的类型、适应证、放置技术、置管和管理中常见的解剖标志，以及与胸腔引流管相关的并发症概述。此外，还探讨了胸管的未来发展方向，以及 COVID-19 大流行期间的胸管管理。
胸管管理具有主观性，但数据的综合可以为最佳实践提供信息，并安全应用于成功管理胸膜腔和改善获得性胸膜腔疾病。
