在胸部创伤患者中实施胸管切除方案:一项前性临床研究
Yassir Abdulrahman1, Mushreq Al-Ani1, Mohammed Farhat1
1Hamad Level 1 Trauma Center, Hamad Medical Corporation, Doha, Qatar.
Journal of thoracic disease
|April 14, 2025
概括
在创伤患者中,早期切除胸腔切除管 (TTs) 是安全且可行的. 虽然发生了一些移除后事件,但并发症率与延迟移除相似,这表明有改善患者结果的潜力.
科学领域:
- 胸部外科手术 胸部外科手术
- 创伤护理 创伤护理
- 关键护理医学 关键护理医学
背景情况:
- 在创伤患者中切除胸管的最佳时间仍然是争论的主题.
- 目前正在研究早期切除胸腔切除管 (TTs) 的可能性,以改善患者的治疗结果.
- 这项研究假设早期的TT切除在创伤患者中既可行又安全.
研究的目的:
- 评估创伤患者早期胸腔切除管切除方案的安全性和有效性.
- 为了比较早期 (≤3天) 和晚期 (>3天) 胸管切除组之间的结果.
主要方法:
- 一项前性临床研究涉及150名创伤患者,这些患者接受了174次胸腔管插入.
- 根据TT移除时间,患者被分为两组:早期 (≤3天) 和晚期 (>3天) 插入后.
- 分析了临床结果,包括复发性肺胸病,血胸病,输卵管脱和移除后的并发症.
主要成果:
- 在174个TTT中,有105个在3天内被移除.
- 在早期切除组 (P=0.09) 中观察到复发性肺胸部病例的轻微,非显著增加.
- 在TT输出150-200毫升/24小时的患者中,复发性肺胸部 (P=0.02) 和再插入 (P=0.002) 显着更高.
- 根据管子大小或插入部位,没有发现并发症或干预措施的显著差异.
结论:
- 在创伤患者中,提前切除胸口管的安全性和并发症率与延迟切除相比较.
- 管的输出体积似乎是影响复发性肺胸部和再插入风险的关键因素.
- 建议在更大的多中心研究中进一步验证,以确认TT去除协议.
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