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在解剖肺切除后,不论排水量如何,早期切除胸管:一个多中心,随机,受控试验
Kazuya Takamochi1, Tomohiro Haruki2, Shiaki Oh3
1Department of General Thoracic Surgery, Juntendo University School of Medicine, Tokyo, Japan.
The Journal of thoracic and cardiovascular surgery
|February 13, 2024
概括
肺切除后早期的胸管切除是安全的和可行的. 这种方法,无论排水量如何,都能减少胸腔管的持续时间,而不会增加不良事件,从而改善患者的康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 外科手术的结果
背景情况:
- 肺切除后的胸管管理对于患者的康复至关重要.
- 目前的做法往往涉及长时间的胸管排水基于体积,可能延迟恢复.
研究的目的:
- 评估在解剖肺切除后提前切除胸管的安全性和可行性.
- 为了比较早期和传统的胸管切除策略之间的呼吸相关不良事件.
主要方法:
- 进行了一项多中心的,随机的,受控的,非劣等性试验.
- 术后第一天排水量>300毫升的患者被随机分为早期清除 (术后第二天) 或常规清除 (排水量≤300毫升/24小时).
- 主要终点是30天内发生≥2级呼吸相关不良事件的频率.
主要成果:
- 175名患者被随机分组;早期切除组中的10人 (11.4%) 和常规组中的12人 (14.0%) 经历了不良事件 (P=.008).
- 早期切除组的胸管持续时间显着较短 (中位数为2天与3天;P<.001).
- 在胸腔整形/重置率或术后住院时间方面没有发现显著差异.
结论:
- 早期的胸管切除,无论排水量如何,是解剖肺切除后的安全和可行的策略.
- 这种方法可以在不影响患者安全的情况下缩短胸腔管的持续时间.
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