Wong K, Goldstraw P
Department of Thoracic Surgery, Royal Brompton Hospital, London, England.
Ann Thorac Surg. 1997 Oct;64(4):979-81. doi: 10.1016/s0003-4975(97)00820-5.
Intraoperative use of fibrin glue has been advocated in reducing postthoracotomy alveolar air leak, although most studies have not been randomized and have focused on its routine use after lung resection.
This study specifically addresses the effectiveness of fibrin glue in reducing alveolar air leak only in patients considered intraoperatively to have continued moderate to severe alveolar air leak after all conventional measures to reduce it have been used.
During a 24-month period, 66 patients undergoing lobectomies, segmentectomies, or decortication were randomized either to serve as controls (n = 33) or to have fibrin glue sprayed on the "raw" lung surface (n = 33). The median duration of intercostal drainage and in-hospital stay was 6 and 9 days, respectively, in the control group and 6 and 8 days, respectively, when fibrin glue was used. Statistical analysis revealed no differences between the groups.
Fibrin glue does not add to conventional techniques in reducing moderate to severe alveolar air leak after thoracic operations.
尽管大多数研究并非随机对照研究且主要关注肺切除术后纤维蛋白胶的常规使用,但术中使用纤维蛋白胶已被提倡用于减少开胸术后肺泡漏气。
本研究专门针对仅在术中被认为在采取所有常规减少措施后仍持续存在中度至重度肺泡漏气的患者,探讨纤维蛋白胶减少肺泡漏气的有效性。
在24个月期间,66例行肺叶切除术、肺段切除术或纤维板剥脱术的患者被随机分为对照组(n = 33)或在“裸露”肺表面喷洒纤维蛋白胶组(n = 33)。对照组肋间引流的中位持续时间和住院时间分别为6天和9天,使用纤维蛋白胶组分别为6天和8天。统计分析显示两组之间无差异。
在减少胸科手术后中度至重度肺泡漏气方面,纤维蛋白胶并未优于传统技术。