Martin T, Fontana G, Olak J, Ferguson M
Department of Surgery, University of Chicago Hospitals, IL 60637, USA.
Chest. 1996 Nov;110(5):1169-72. doi: 10.1378/chest.110.5.1169.
We assessed the use of a pleural catheter (Thoracic Vent) to determine its effectiveness in treating simple pneumothorax (PTX) and in preventing recurrent PTX.
A retrospective review was conducted of 84 patients treated with a pleural catheter for iatrogenic (52) and spontaneous (11 primary, 21 secondary) PTX between 1989 and 1994.
There were 45 men and 39 women with a mean age of 50.4 years (range, 18 to 85 years).
Mean time to lung reexpansion was 0.5 +/- 0.1 days. Forty-five (57%) patients manifested an air leak after catheter placement for 2.0 +/- 0.2 days. The duration of time to catheter removal was 3.3 +/- 0.2 days. Seventy-one (85%) patients had resolution of PTX with this therapy alone. Thirteen patients (15%) failed to resolve their PTXs and required subsequent tube thoracostomy alone (6) or surgical therapy (7). Four of 11 patients who required tube thoracostomy also failed to respond to this therapy. Treatment failure was more common among patients with spontaneous PTX than with iatrogenic PTX (34% vs 4%; p < 0.005). During a mean follow-up of 3.0 +/- 0.2 years, 6 (7%) patients suffered recurrent PTX an average of 23 days after initial therapy.
This pleural catheter is effective in the management of simple iatrogenic and spontaneous PTX.
我们评估了胸膜导管（胸通气导管）在治疗单纯气胸（PTX）及预防复发性PTX方面的有效性。
对1989年至1994年间84例因医源性（52例）和自发性（11例原发性、21例继发性）PTX接受胸膜导管治疗的患者进行回顾性研究。
45名男性和39名女性，平均年龄50.4岁（范围18至85岁）。
肺复张的平均时间为0.5±0.1天。45例（57%）患者在放置导管后出现漏气，持续时间为2.0±0.2天。导管拔除的时间为3.3±0.2天。71例（85%）患者仅通过该治疗气胸即得到缓解。13例（15%）患者气胸未能缓解，随后单独需要进行胸腔闭式引流术（6例）或手术治疗（7例）。11例需要胸腔闭式引流术的患者中有4例对该治疗也无反应。自发性PTX患者的治疗失败比医源性PTX患者更常见（34%对4%；p<0.005）。在平均3.0±0.2年的随访期间，6例（7%）患者出现复发性PTX，平均在初始治疗后23天。
这种胸膜导管在单纯医源性和自发性PTX的治疗中有效。
