胸管排水过程中的并发症 对于iatrogenic肺胸炎
Birgitte Siem Joensen1, Uffe Bodtger2,3, Christian B Laursen4,5
1Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.
European clinical respiratory journal
|January 22, 2025
概括
用胸管治疗的催化性肺胸炎具有显著但可以接受的生命危险事件风险,特别是在患有先前存在的肺部问题或延迟肺部扩张的患者中. 谨慎的患者选择是安全的门诊管理的关键.
科学领域:
- 肺部医学 肺部医学
- 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:
- 阴性肺胸炎是肺部手术的常见并发症.
- 目前针对原发性自发性肺胸炎的指导方针不涉及弱势群体中阳性病例.
- 缺乏用于 ambulatory 治疗 iatrogenic 肺胸的安全性数据,特别是在老年,并发症或虚弱的患者中.
研究的目的:
- 评估胸腔管治疗阳性性肺胸炎的安全性.
- 确定这些患者与危及生命的事件相关的风险因素.
主要方法:
- 对97名患者进行了回顾性队列研究,这些患者接受了粘合集成胸腔管系统的治疗.
- 主要结局:需要紧急干预的危及生命的事件发生率.
- 二次结局:严重的不良事件,不良事件和与设备相关的事件;对门诊门诊治疗安全性的评估.
主要成果:
- 发生了6个 (6%) 危及生命的事件,包括呼吸衰竭和需要重新插入.
- 在切除前和率<95%的患者中,事件发生率 (21%) 较高,而和率>=95% (p=0.003) 的患者为1%.
- 如果肺部在胸管插入后没有完全扩张 (25%),与部分 (2%) 或完全扩张 (4%) (p=0.009) 相比,事件发生率更高.
结论:
- 胸腔管治疗阳性肺胸病具有严重的生命危险事件的风险.
- 风险是可以接受的,患者的肺功能保存和早期治疗反应.
- 患者的选择对于安全管理至关重要,考虑到手术前的肺部状况和初始治疗反应.
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