肺切除后最佳吸管策略使用单个布莱克排水的数字排水系统:一项随机研究
Conor M Maxwell1, Benny Weksler2, Kevin Shahbahrami3
1Department of Surgery, Allegheny General Hospital, Pittsburgh, PA, USA.
Innovations (Philadelphia, Pa.)
|August 1, 2025
概括
低吸量 (LS) 与标准吸量 (SS) 相比,没有缩短肺切除后的空气泄漏时间. 当空气泄漏存在时,尽管胸腔管的持续时间和住院时间相似,但可能更喜欢标准吸气.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部医学 肺部医学
- 关键护理医学 关键护理医学
背景情况:
- 肺切除后的胸管管理缺乏标准化.
- 实践在吸水水平,排水类型和清除标准上有所不同.
研究的目的:
- 为了比较标准吸管 (SS) 和低吸管 (LS) 在微创肺切除后的胸管管理.
- 评估空气泄漏持续时间的主要结果和包括胸腔管持续时间和停留时间在内的次要结果.
主要方法:
- 一项随机研究将SS (-20 cmH2O) 与LS (-8 cmH2O) 进行了比较,这些患者接受了微创肺切除.
- 根据排水量 (≤450毫升/24小时) 和空气泄漏率 (≤20毫升/分钟超过6小时) 移除了胸腔管.
主要成果:
- 在SS和LS组之间,没有观察到空气泄漏时间,胸管持续时间或住院时间的显著差异.
- 长期空气泄漏的发生率相似 (8%的SS与11%的LS).
- 低吸量与更多的肺部干预 (11%对3%) 和增加皮下肺的趋势有关.
结论:
- 单个24 Fr布莱克排水和450 cc/24 h排水值是安全有效的胸管去除.
- 低吸度对空气泄漏持续时间而言,与标准吸度相比,没有任何优势.
- 标准吸可能是可取的,因为更高的需要腔干预和增加的皮下肺气与低吸的趋势.
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