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猪尾导管与传统胸腔引流管在气胸病例中的应用比较研究。

Comparative Study between the Use of Pigtail Catheters and Traditional Chest Tube Drain in Cases with Pneumothorax.

机构信息

Department of Surgery, Cardio Thoracic and Vascular Surgery Unit, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2022 Jan-Mar;20(77):24-28.

Abstract

Background Pneumothorax is a condition in which air or other gas is present in the pleural cavity. Mainstay of management of pneumothorax is to remove the air from the pleural space usually done by chest tube insertion. There is still uncertainty whether minimal invasive management with pigtail catheter is sufficient for the management of pneumothorax. Objective To find the effectiveness, safety, tolerability, efficacy of pigtail catheters and large bore chest tubes. Method Prospective comparative study was done in Dhulikhel Hospital between August 2019 till August 2021. Chest tube insertion used to be the only available treatment modality till December 2020 (15 months). Following January 2021 after obtaining ethical clearance for use of pigtail insertion for pneumothorax, this treatment modality was done (8 months). Result Among 76 patients, 52(68.4%) underwent a large bore chest tube and 24 (34.6%) pigtail catheter patients. Mean age of the patients was 48 years (SD 18.01). Duration of hospital stay and length of hospital stay was more in large bore catheters and less in pigtail catheters. Eight hours post tube placement of the expansion of the lungs was present in pigtail and was statistically significant. Pain killer used in pigtail catheters was limited to Non-steroidal anti-inflammatory drugs, for large bore catheter opioids were added and were statistically significant. Conclusion Pigtail catheter is nearly effective as compared to traditional wide bore catheters.

摘要

背景

气胸是指空气或其他气体存在于胸膜腔内的一种状况。气胸的主要治疗方法是通过胸腔引流管插入将胸膜腔内的空气排出。目前仍不确定使用猪尾导管进行微创管理是否足以治疗气胸。目的:寻找猪尾导管和大口径胸腔引流管的有效性、安全性、耐受性和疗效。方法:在 2019 年 8 月至 2021 年 8 月期间,在 Dhulikhel 医院进行了前瞻性对比研究。直到 2020 年 12 月(15 个月),胸腔引流管插入一直是唯一可用的治疗方式。2021 年 1 月,在获得使用猪尾插入治疗气胸的伦理批准后,开始使用这种治疗方式(8 个月)。结果:在 76 名患者中,52 名(68.4%)接受了大口径胸腔引流管治疗,24 名(34.6%)接受了猪尾导管治疗。患者的平均年龄为 48 岁(标准差 18.01)。大口径引流管的住院时间和住院时间均较长,而猪尾导管的住院时间和住院时间均较短。猪尾导管放置后 8 小时,肺部扩张情况较好,差异有统计学意义。猪尾导管中使用的止痛药仅限于非甾体抗炎药,而大口径引流管中则添加了阿片类药物,差异有统计学意义。结论:与传统大口径导管相比,猪尾导管的疗效相当。

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