Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore.
Pulm Med. 2023 Dec 18;2023:6340851. doi: 10.1155/2023/6340851. eCollection 2023.
We conducted a retrospective review of patients with pleural infection requiring intrapleural therapy at two tertiary referral centres.
We included 84 (62.2%) and 51 (37.8%) patients who received sequential and concurrent intrapleural therapy, respectively. Patient demographics and clinical characteristics, including age, RAPID score, and percentage of pleural opacity on radiographs before intrapleural therapy, were similar in both groups. Treatment failure rates (defined by either in-hospital mortality, surgical intervention, or 30-day readmission for pleural infection) were 9.5% and 5.9% with sequential and concurrent intrapleural therapy, respectively ( = 0.534). This translates to a treatment success rate of 90.5% and 94.1% for sequential and concurrent intrapleural therapy, respectively. There was no significant difference in the decrease in percentage of pleural effusion size on chest radiographs (15.1% [IQR 6-35.7] versus 26.6% [IQR 9.9-38.7], = 0.143) between sequential and concurrent therapy, respectively. There were also no significant differences in the rate of pleural bleeding (4.8% versus 9.8%, = 0.298) and chest pain (13.1% versus 9.8%, = 0.566) between sequential and concurrent therapy, respectively.
Our study adds to the growing literature on the safety and efficacy of concurrent intrapleural therapy in pleural infection.
我们对在两家三级转诊中心因胸膜感染而需要行胸膜腔内治疗的患者进行了回顾性研究。
分别有 84（62.2%）例和 51（37.8%）例患者接受了序贯性和同时性胸膜腔内治疗。两组患者的人口统计学和临床特征，包括年龄、RAPID 评分以及胸膜腔内治疗前 X 线胸片上的胸膜不透明度百分比，均相似。治疗失败率（定义为住院死亡率、手术干预或胸膜感染 30 天再入院）分别为序贯性和同时性胸膜腔内治疗的 9.5%和 5.9%（=0.534）。这分别相当于序贯性和同时性胸膜腔内治疗的治疗成功率为 90.5%和 94.1%。两组患者的 X 线胸片上胸腔积液大小百分比的降低程度（分别为 15.1%[IQR 6-35.7]与 26.6%[IQR 9.9-38.7]，=0.143）也没有显著差异。序贯性和同时性治疗的胸腔出血发生率（分别为 4.8%与 9.8%，=0.298）和胸痛发生率（分别为 13.1%与 9.8%，=0.566）也没有显著差异。
本研究增加了关于同时性胸膜腔内治疗在胸膜感染中的安全性和疗效的不断增长的文献。
