肺切除术后指胸引流的临床评价及效果。

F. Shoji, S. Takamori, T. Akamine, G. Toyokawa, Y. Morodomi, T. Okamoto, Y. Maehara
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引用次数: 14

摘要

模拟胸腔引流系统(ACS)通常用于监测肺切除术后肺泡漏气(PAL)。电子数字胸腔引流系统(DCS)最近被开发出来,据报道它比传统的ACS有几个优点。在这里,我们报告一个机构的经验,PAL管理与DCS。我们还试图确定DCS与ACS相比是否具有更好的临床益处和结果。方法:我们招募了112例连续接受肺切除术并随后进行DCS治疗的患者。我们使用倾向评分匹配法比较了121例连续肺切除术后ACS患者的PAL率、胸腔引流时间和并发症发生率。结果DCS胸腔引流术中PAL平均最大值48.9 ml/min(范围:2.0 ~ 868.6 ml/min),最小值0.1 ml/min(范围:0.0 ~ 1.2 ml/min)。DCS去除的PAL平均速率为1.3 ml/min (0.0-10.0 ml/min)。倾向评分匹配后,DCS组胸腔引流的平均持续时间明显短于ACS组(分别为2.7天,范围1-9天,3.7天,范围1-21天);P = 0.031)。结论肺切除术后用DCS处理PAL可缩短胸腔引流时间。
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Clinical Evaluation and Outcomes of Digital Chest Drainage after Lung Resection.
BACKGROUND Analog chest drainage systems (ACS) are generally used to monitor postoperative alveolar air leakage (PAL) after lung resection. An electronic digital chest drainage system (DCS) has recently been developed that reportedly has several advantages over the traditional ACS. Here, we report a single institution's experience of PAL management with the DCS. We also sought to establish whether DCS had superior clinical benefits and outcomes compared with ACS. METHODS We enrolled 112 consecutive patients who underwent lung resection and were subsequently managed with DCS. We compared PAL rate, duration of chest drainage, and the incidence of complications with a group of 121 consecutive patients previously managed with ACS after lung resection, using propensity score matching. RESULTS Mean maximum and minimum PAL rates during DCS chest drainage were 48.9 ml/min (range: 2.0-868.6 ml/min) and 0.1 ml/min (0.0-1.2 ml/min), respectively. Mean PAL rate at DCS removal was 1.3 ml/min (0.0-10.0 ml/min). After propensity score matching, mean duration of chest drainage was significantly shorter with DCS than ACS (2.7 days, range: 1-9 days, compared with 3.7 days, range: 1-21 days, respectively; P = 0.031). CONCLUSIONS Managing PAL with DCS after pulmonary resection appears to reduce the duration of chest drainage.
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