摘要
目的探讨胸腔引流管径的大小对患者预后的影响。方法回顾性分析2010年1月至2019年12月航天中心医院收治因胸部创伤而进行胸腔引流管置入的74例患者资料,评估患者特征与引流管的大小、额外置管的风险和并发症的相关性。结果74例患者置入胸管86根,77根引流管作为初始引流管(3例患者需要双侧引流),9根为额外放置的引流管(置管原因分别为残余气胸3例,残余血胸4例,残余血气胸1例,胸腔外放置不当1例),附加引流管的管径与初始引流管相比较,差异无显著性(P=0.19,95%CI:-1.62~4.95)。初始置管放置的大小与患者的性别、指征、呼吸状态(有无气管插管)、受伤机制无相关性;引流管的大小与患者的年龄、体重指数、修订后的创伤评分、损伤严重程度评分、适应证、胸部损伤简短量表评分无相关性。按引流管大小将患者分为≥14 Fr组和<14 Fr组,两组间需要额外插管、血肿/气胸残留、胸膜外放置不当的风险差异无显著性,不需要额外的导管或手术干预治疗导管阻塞或残留的血胸凝块。结论在胸部外伤患者中放置<14 Fr引流管,残余血肿/气胸和阻塞引流的风险并未增加,引流充分有效。
Objective To investigate the influence of the size of the chest tube size on the prognosis of patients.Method A retrospective analysis of the data of 74 patients who underwent chest tube insertion due to chest trauma in the Aerospace Center Hospital from Jan 2010 to Dec 2019 was retrospectively analyzed,and the characteristics of the patients and the size of the tube,the risk and complications of additional tube insertion were evaluated.Result 86 chest tubes were placed in 74 patients,77 tubes were used as initial drainage tubes(3 patients required bilateral drainage),and 9 additional chest tubes were placed(the reasons for the placement of tubes were 3 cases of residual pneumothorax,4 cases of residual hemothorax,1 case of residual blood pneumothorax,1 case of improper placement outside the chest),the diameter of the additional chest tube compared with the initial chest tube,the difference was not significant(P=0.19,95%CI:-1.62~4.95).The size of the initial catheter placement is not related to the patient’s gender,indications,respiratory status(with or without tracheal intubation),and injury mechanism;the size of the chest tube is related to the patient’s age,body mass index,revised trauma score,injury severity scale,indications,and chest injury short scale scores were not correlated.Patients were divided into≥14 Fr group and<14 Fr group according to the size of the chest tube.There was no significant difference in the risk of additional intubation,residual hematoma/pneumothorax,and improper extrapleural placement between the two groups,and no additional catheter or surgical intervention was required when there were obstructed catheters or remaining hemothorax clots.Conclusion Placing a chest tube<14 Fr in patients with chest trauma does not increase the risk of residual hematoma/pneumothorax and obstructed drainage,and the drainage is sufficiently effective.
作者
王烽
王旭东
刘文海
Wang Feng;Wang Xudong;Liu Wenhai(Aerospace Center Hospital,Beijing 100049,China)
出处
《中国临床医生杂志》
2021年第5期535-537,共3页
Chinese Journal For Clinicians
基金
中国航天科工医疗卫生科研项目(2019-LCYL-014)。
关键词
胸部创伤
胸腔引流管
回顾性分析
血胸
气胸
thoracic trauma
chest tube
retrospective analysis
hemothorax
pneumothorax
