创伤性血胸部的小与大孔胸腔切除术:一个系统的审查和元分析
Nicole B Lyons1, Mohamed O Abdelhamid, Brianna L Collie
1From the Divisions of Trauma, Surgical Critical Care, and Burns, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, Miami, Florida.
The journal of trauma and acute care surgery
|August 30, 2024
概括
小孔管胸口切除术 (SBTT) 与大孔管胸口切除术 (LBTT) 在治疗创伤性血胸 (HTX) 中同样有效. SBTT提供更高的初始排水和更少的管道日,而不会增加失败,死亡率或并发症率.
科学领域:
- 创伤外科 手术 创伤外科
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 创伤性血胸 (HTX) 是一个常见的胸部损伤.
- 管胸切除术是HTX的标准治疗方法.
- 管胸切除术的最佳导管大小仍在争论中.
研究的目的:
- 为了比较小孔管胸腔切除术 (SBTT) (≤14 F) 与大孔管胸腔切除术 (LBTT) (≥20 F) 对创伤性HTX的有效性.
- 为了测试SBTT与LBTT不逊色的假设.
主要方法:
- 随机对照试验和队列研究的系统审查和元分析.
- 在PubMed,EMBASE,Scopus和Cochrane评论中搜索到2022年11月.
- 主要结局是失败率 (不完全排出或保留的HTX需要重新干预).
主要成果:
- 纳入了9项涉及1847名患者的研究 (714名SBTT,1233名LBTT).
- 失败率相似:SBTT的17.8%,而LBTT的21.5% (p=0.166).
- SBTT显示出更高的初始排水量和更少的输管日,死亡率和并发症率相似.
结论:
- 小孔管胸腔切除术 (SBTT) 是治疗创伤性血胸术的大孔管胸腔切除术 (LBTT) 的可行和有效替代方案.
- 在排水效率和资源利用方面,SBTT可能具有优势.
- 进一步的研究可能会澄清每个技术的最佳指示.
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