Alomar Zubaidah, Tawfek Zainab, Alomar Yousif, Mahmood Ismail, Alomar Ali, El-Menyar Ayman, Rizoli Sandro, Al-Thani Hassan
Jordan University of Science and Technology, Irbid, Jordan.
Emergency Department, Al Ahli Hospital, Doha, Qatar.
Qatar Med J. 2025 Jun 9;2025(2):55. doi: 10.5339/qmj.2025.55. eCollection 2025.
Pleural diseases are common and often require drainage, with the growing use of small-bore chest drains (SBCDs) instead of larger tubes. This review aimed to examine the failure rate and complications associated with SBCD use in different pleural pathologies.
A literature search (PubMed, SCOPUS, and Google Scholar) was performed on the complications associated with SBCDs to treat pleural diseases. This review analyzed patient demographics, indications, outcomes, failure rate, and complications associated with the use of SBCDs. The systematic review was conducted using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.
Thirty studies were included in this review with 4,973 patients. The indications for insertions of SBCDs were pleural effusion at 48.4%, pneumothorax at 30.1%, empyema or parapneumonic effusion at 11.4%, hemothorax at 6.5%, and other indications at 3.6%. The overall failure rate to achieve satisfactory drainage was 19.4%. Significant complications included iatrogenic pneumothorax at 11.9%, major hemorrhage at 1.0%, local bleeding at 0.7%, infection at 1.2%, and iatrogenic organ injury at 0.9%. Other insertional complications included tube dislodgement at 5.9%, tube blockage at 5.4%, tube kinking at 3.7%, misplacement at 3.3%, and subcutaneous hematoma at 0.5%. Most of the data published revolves around hemodynamically stable patients with SBCD insertions and is, thus, deficient regarding hemodynamically unstable patients.
Despite carrying notable failure rates and complications, small-bore catheters remain an acceptable option for managing selected pleural diseases.
胸膜疾病很常见，通常需要进行引流，如今越来越多地使用小口径胸腔引流管（SBCD）而非较大的引流管。本综述旨在研究在不同胸膜病变中使用SBCD的失败率及相关并发症。
针对与SBCD治疗胸膜疾病相关的并发症进行了文献检索（PubMed、SCOPUS和谷歌学术）。本综述分析了患者的人口统计学特征、适应证、治疗结果、失败率以及与使用SBCD相关的并发症。系统评价按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行。
本综述纳入了30项研究，共4973例患者。插入SBCD的适应证为胸腔积液占48.4%，气胸占30.1%，脓胸或肺炎旁胸腔积液占11.4%，血胸占6.5%，其他适应证占3.6%。实现满意引流的总体失败率为19.4%。显著并发症包括医源性气胸占11.9%，大出血占1.0%，局部出血占0.7%，感染占1.2%，医源性器官损伤占0.9%。其他插入相关并发症包括引流管移位占5.9%，引流管堵塞占5.4%，引流管扭曲占3.7%，位置不当占3.3%，皮下血肿占0.5%。大多数已发表的数据围绕血流动力学稳定的患者插入SBCD展开，因此在血流动力学不稳定的患者方面存在不足。
尽管存在显著的失败率和并发症，但小口径导管仍是治疗某些胸膜疾病的可接受选择。
