创伤性胸管理冠状动脉旁路移植后 - 一个系统的审查
Gavin John Carmichael1,2, Duron Prinsloo1,3, Connor Bentley1,4
1University of Melbourne, Melbourne, Victoria, Australia.
Asian cardiovascular & thoracic annals
|February 24, 2025
概括
冠状动脉旁路移植 (CABG) 手术可能会导致胆胸部,一种罕见的肺部溢液. 最初的管理是保守的,但高输出病例需要手术干预,突出需要标准化后CABG胆胸指南.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 胃肠病学 胃肠病学
背景情况:
- 冠状动脉旁路移植 (CABG) 手术是一种常见的手术,具有显著的益处.
- 胸,CABG的一种罕见并发症,是由于胸管外伤和肌积累造成的.
- 目前的管理缺乏国际指导方针,需要对现有战略进行审查.
研究的目的:
- 为了提供一个全面的概述当前的管理策略,为chylothorax后CABG.
- 确定有效的治疗方法,并突出未来指导方针开发的领域.
主要方法:
- 对EMBASE,Cochrane,Ovid和PubMed数据库进行了系统审查.
- 纳入标准侧重于CABG后的胆胸管理和临床结果.
- 分析了11个病例报告 (14个病例) 的数据.
主要成果:
- 在所有情况下,保守的管理 (TPN,无口服,八胺,低脂肪饮食) 是最初的方法.
- 高输出胆胸 (>1000毫升/天) 经常需要在12.5天后进行手术干预.
- 手术的选择包括胸管绑定 (3/3的病例有效) 和栓塞 (1/1的病例成功).
结论:
- 在CABG后,胆胸部的管理从保守开始,在高输出病例中升级到手术.
- 对于手术时间和药物治疗 (octreotide, somatostatin) 的标准化准则有着至关重要的需要.
- 需要进一步进行高强度的研究来验证发现并建立最终的临床指南.
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