Collop N A, Kim S, Sahn S A
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston 29425, USA.
Chest. 1997 Sep;112(3):709-13. doi: 10.1378/chest.112.3.709.
To evaluate all tube thoracostomies (TTs) done by pulmonary/critical care fellows and attending physicians in the Medical University of South Carolina's health-care system documenting patient demographics, indication for placement, size and characteristics of the tube, and associated problems.
Prospective.
University health-care system, including a university hospital, a Veterans Affairs hospital, and a county hospital.
All adult patients requiring consultation by a member of the pulmonary/critical care staff for a tube thoracostomy.
One hundred twenty-six tube thoracostomies were performed over a 24-month period in 91 patients. The most common initial indication for a TT was pneumothorax (69/103, 67%). Overall mortality in the patient population was 35% (32/91). Early problems (< 24 hours following placement) occurred in 3% (4/126); late problems (> 24 h after placement) occurred in 8% (10/126). Problems occurred in 36% (4/11) of small-bore tube placements vs 9% (10/115) of standard TT placements (p=0.02).
Tube thoracostomy can be safely performed by pulmonologists with relatively few associated problems.
评估南卡罗来纳医科大学医疗系统中肺科/重症医学进修医生和主治医生所进行的所有胸腔闭式引流术（TTs），记录患者人口统计学资料、置管指征、引流管的尺寸和特征以及相关问题。
前瞻性研究。
大学医疗系统，包括一所大学医院、一所退伍军人事务医院和一所县医院。
所有需要肺科/重症医学科工作人员会诊以进行胸腔闭式引流术的成年患者。
在24个月期间，对91例患者进行了126次胸腔闭式引流术。胸腔闭式引流术最常见的初始指征是气胸（69/103，67%）。患者总体死亡率为35%（32/91）。早期问题（置管后<24小时）发生率为3%（4/126）；晚期问题（置管后>24小时）发生率为8%（10/126）。小口径引流管置管的问题发生率为36%（4/11），而标准胸腔闭式引流术置管的问题发生率为9%（10/115）（p=0.02）。
肺科医生可以安全地进行胸腔闭式引流术，相关问题相对较少。
