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采用自体血和50%葡萄糖溶液对术后漏气进行早期胸膜固定术。

Early Pleurodesis for Postoperative Air Leak with Autologous Blood and 50% Glucose Solution.

作者信息

Hong Jeong In, Lee Jun Hee, Kim Hyun Koo

机构信息

Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

出版信息

J Chest Surg. 2023 Jan 5;56(1):16-22. doi: 10.5090/jcs.22.096. Epub 2022 Dec 19.

Abstract

BACKGROUND

Postoperative air leaks after pulmonary resection prolong the duration of chest drainage and the length of hospital stay. One of the many treatment options is bedside pleurodesis using various agents. This study evaluated the feasibility of an early intervention to stop postoperative air leaks with either autologous blood or a 50% glucose solution.

METHODS

We retrospectively reviewed 323 patients who underwent bedside pleurodesis between January 2017 and March 2022. Sixty-four patients received autologous blood patch pleurodesis, and 36 were treated with a 50% glucose solution after pulmonary resection. The primary endpoints were the total postoperative tube indwelling time, post-pleurodesis tube indwelling time, and hospital stay. A propensity score-matched analysis was performed.

RESULTS

In the autologous blood patch pleurodesis and 50% glucose solution groups, the mean initiation timing of postoperative pleurodesis were 2.06±1.62 and 3.28±1.56 days, the mean duration of the tube indwelling time after surgery was 6.58±3.02 and 6.42±4.92 days, and the mean duration of the tube indwelling time after pleurodesis, it was 4.53±3.10 and 3.11±4.80 days, respectively. In addition, the total length of hospital stay was 9.11±5.42 and 7.83±4.75 days in the autologous blood patch pleurodesis and 50% glucose solution groups, respectively.

CONCLUSION

Early postoperative air leak cessation with autologous blood patch pleurodesis or 50% glucose solution pleurodesis is a feasible procedure with acceptable outcomes that effectively shortens the hospital stay.

摘要

背景

肺切除术后的漏气会延长胸腔引流时间和住院时间。众多治疗选择之一是使用各种药物进行床旁胸膜固定术。本研究评估了采用自体血或50%葡萄糖溶液进行早期干预以停止术后漏气的可行性。

方法

我们回顾性分析了2017年1月至2022年3月期间接受床旁胸膜固定术的323例患者。64例患者接受了自体血补片胸膜固定术,36例患者在肺切除术后接受了50%葡萄糖溶液治疗。主要终点是术后总置管时间、胸膜固定术后置管时间和住院时间。进行了倾向评分匹配分析。

结果

在自体血补片胸膜固定术组和50%葡萄糖溶液组中,术后胸膜固定术的平均开始时间分别为2.06±1.62天和3.28±1.56天,术后置管平均时间分别为6.58±3.02天和6.42±4.92天,胸膜固定术后置管平均时间分别为4.53±3.10天和3.11±4.80天。此外,自体血补片胸膜固定术组和50%葡萄糖溶液组的总住院时间分别为9.11±5.42天和7.83±4.75天。

结论

采用自体血补片胸膜固定术或50%葡萄糖溶液胸膜固定术在术后早期停止漏气是一种可行的方法,效果良好,可有效缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f68/9845852/df07885ffe34/jcs-56-1-16-f1.jpg

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