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肺切除术后持续漏气患者额外放置胸管的安全性和有效性:一项倾向评分匹配分析。

The safety and efficacy of additional chest tube placement in patients with prolonged air leaks after pulmonary resection: a propensity score-matched analysis.

作者信息

Hua Qingwang, Liu Suyue, Shen Lu, Yang Zhenhua, Shen Haibo

机构信息

Department of Thoracic Surgery, Ningbo No.2 Hospital, Ningbo, China.

出版信息

Front Med (Lausanne). 2024 Oct 8;11:1484327. doi: 10.3389/fmed.2024.1484327. eCollection 2024.

Abstract

BACKGROUND

This study evaluates the symptomatic management of prolonged pleural air leaks following pulmonary resection, assesses the efficacy and safety of chest tube placement, and introduces experiences with high-positioned chest tube insertion.

METHODS

We retrospectively reviewed 84 patients with prolonged pleural air leaks after lung surgery at Ningbo No.2 Hospital from January 2022 to December 2023. These patients were divided into a conservative treatment group (Group A, = 64) and a chest tube placement group (Group B, = 20). The propensity score matching method was applied to balance confounders between the two groups, resulting in 12 matched pairs. The study compared the time to chest tube removal, average hospital stays time, postoperative drainage volume, and facial visual analog pain score between the two groups.

RESULTS

The average hospital stays and chest tube removal time of patients in group B were significantly lower than those of patients in group A (8.00 ± 1.12 vs. 9.75 ± 1.60 days, = 0.003, 6.92 ± 1.08 vs. 8.58 ± 1.67 days, = 0.005, respectively). However, the mean facial visual analog pain score in group B was higher than that in group A (1.58 ± 0.58 vs. 1.00 ± 0.01, = 0.020). There were no significant differences between the two groups in terms of postoperative drainage volume.

CONCLUSIONS

For patients with prolonged air leaks, additional chest tube placement postoperatively significantly reduces both hospitals stay duration and chest tube indwelling time compared to conservative treatment. This method may be a potential treatment measure for prolonged air leak in selected patients.

摘要

背景

本研究评估肺切除术后持续性气胸漏气的对症处理,评估胸腔闭式引流管放置的有效性和安全性,并介绍高位胸腔闭式引流管置入的经验。

方法

回顾性分析2022年1月至2023年12月在宁波市第二医院接受肺手术后出现持续性气胸漏气的84例患者。将这些患者分为保守治疗组(A组,n = 64)和胸腔闭式引流管放置组(B组,n = 20)。采用倾向评分匹配法平衡两组间的混杂因素,最终形成12对匹配病例。比较两组患者拔管时间、平均住院时间、术后引流量及面部视觉模拟疼痛评分。

结果

B组患者的平均住院时间和拔管时间显著低于A组患者(分别为8.00±1.12天对9.75±1.60天,P = 0.003;6.92±1.08天对8.58±1.67天,P = 0.005)。然而,B组患者的平均面部视觉模拟疼痛评分高于A组(1.58±0.58对1.00±0.01,P = 0.020)。两组患者术后引流量差异无统计学意义。

结论

对于持续性气胸漏气患者,与保守治疗相比,术后额外放置胸腔闭式引流管可显著缩短住院时间和胸腔闭式引流管留置时间。该方法可能是部分持续性气胸漏气患者的一种潜在治疗措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3869/11493618/b03a19973925/fmed-11-1484327-g0001.jpg

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