主要な自発性肺胸炎の ambulatory 管理:オープンラベル,ランダム化制御試験
Rob J Hallifax1, Edward McKeown2, Parthipan Sivakumar3
1Oxford Centre for Respiratory Medicine, University of Oxford, Oxford, UK.
Lancet (London, England)
|July 6, 2020
まとめ
主要な自発性肺胸炎 (PSP) の外来治療は,入院期間を大幅に短縮します. しかし,このアプローチは標準治療と比較して有害事象の発生率が高い.
科学分野:
- 胸部 外科
- 肺科
- 医療機器
背景:
- 主要な自発性肺胸炎 (PSP) は,若くて健康な個人に影響します.
- 現在の管理戦略は 長期間の入院につながります
- 野外療法によるPSPの有効性と安全性に関するデータは限られている.
研究 の 目的:
- PSP の患者で, ambulatory 治療に対する入院期間を比較する.
- PSPの ambulatory 管理の安全性を評価する.
主な方法:
- イギリスの24の病院で236人の成人 (16歳~55歳) を対象としたオープン・ランドマイズ・コントロール試験です.
- 患者は無作為に ambulatory device または標準的なガイドラインに基づく治療 (吸入,胸管挿入,または両方) に割り当てられました.
- 主な評価項目は,30日以内の再入院を含む,入院期間でした.
主要な成果:
- 標準治療 (4日;p< 0. 0001) と比較して,出院管理により,平均入院期間が著しく短縮されました.
- 47%の患者で有害事象が発生し,出院治療群では55%で,標準治療群では39%でした.
- 全14件の重篤な有害事象は,外来治療群で発生し,8件は介入に関連したものです.
結論:
- PSPの ambulatory managementは,入院期間と30日以内に再入院を大幅に短縮します.
- このアプローチは,有害事象のリスクの増加と関連しています.
- 外科医の介入が必要な患者では,PSPの管理に適しているかもしれません.
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