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Clamping trials prior to thoracostomy tube removal and the need for subsequent invasive pleural drainage.

拔除胸腔造瘘管前的钳夹试验和后续侵入性胸腔引流的必要性。

  • 影响因子:2.11
  • DOI:10.1016/j.amjsurg.2020.01.007
  • 作者列表:"Becker JC","Zakaluzny SA","Keller BA","Galante JM","Utter GH
  • 发表时间:2020-01-08
Abstract

BACKGROUND:There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. METHODS:We conducted a retrospective cohort study of trauma patients who underwent tube thoracostomy during 2009-2015. We compared patients who underwent clamping trials to those who did not, adjusting for confounders. The primary outcome was subsequent ipsilateral pleural drainage within 30 days. RESULTS:We evaluated 214 clamping trial and 285 control patients. Only two of 214 patients failed their clamping trial and none developed a tension pneumothorax [0.0% (95% CI 0.0-1.7%)]. Clamping trials were associated with fewer pleural drainage procedures [13 (6%) vs. 33 (12%); adjusted OR 0.41 (95% CI 0.20-0.84)]. CONCLUSIONS:A clamping trial prior to thoracostomy tube removal seems to be safe and was associated with less likelihood of a subsequent pleural drainage procedure.

摘要

背景: 很少有证据支持或反驳钳夹试验,即在取出前夹闭胸腔造瘘管一段时间。我们试图评估钳夹试验是否减少了后续胸膜引流手术的需要。 方法: 我们对 2009-2015 年期间接受管状胸廓造口术的创伤患者进行了一项回顾性队列研究。我们比较了接受钳夹试验的患者与未接受钳夹试验的患者,调整了混杂因素。主要结局是 30 天内随后同侧胸腔引流。 结果: 我们评估了 214 例钳夹试验和 285 例对照患者。214 例患者中只有 2 例钳夹试验失败,无一例发生张力性气胸 [0.0% (95% CI 0.0-1.7%)]。钳夹试验与较少的胸膜引流程序相关 [13 (6%) vs.33 (12%); 调整后的 OR 0.41 (95% CI 0.20-0.84)]。 结论: 在拔除胸腔造瘘管之前进行钳夹试验似乎是安全的,并且与随后进行胸腔引流手术的可能性较小相关。

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