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Experience with Pigtail Tube Drainage Treatment for Spontaneous Pneumothorax With and Without a Water Seal

自發性氣胸以豬尾巴管治療包括單向閥門引流袋及水下引流之處理經驗

摘要


在此我們報告以豬尾巴管治療治療原發性自發性氣胸之經驗,包括以豬尾巴管連接單向閥門引流袋及連接水下引流瓶系統,並與傳統胸管引流術作比較。從1997年1月到2002年9月,我們分析了170位原發性自發性氣胸之病人,其中103人接受豬尾巴管引流治療(82位病人接受豬尾巴管連接單向閥門引流袋治療,21位接受以豬尾巴管連接水下引流瓶系統),其餘67位接受傳統胸管引流術治療。在拔管時間、住院日、吸收速度、及住院費用比較上接近、並無顯著差異。以傳統胸管引流之成功率為78%,15位病人因吸收效果不佳、發生血胸或個人因素後續接受手術治療;而以豬尾巴管治療之成功率為70%,有31位病人亦因相同原因後續接受其他治療包括以胸管引流或手術治療。在豬尾巴管連接單向閥門引流袋治療及連接水下引流瓶系統之間的比較上:水下引流瓶組在拔管時間、住院日、吸收速度未呈現明顯優勢,而住院費用反而較高。以豬尾巴管治療原發性自發性氣胸是明顯有效,但並未優於傳統胸管引流術,這與我們起初的假設符合,但加上考慮簡易技術施行、病人行動方便性、較小的傷口及病人舒適性,以豬尾巴管連接單向閥門引流袋可以考慮當作原發性自發性氣胸的第一線治療。

關鍵字

氣胸 胸管 豬尾巴管

並列摘要


We report our experience with pigtail tube drainage in the treatment of spontaneous pneumothorax, including the use of the pigtail with a one-way-valve bag only and with the water-sealed bottle system, and compare this to the traditional chest tube thoracotomy. One hundred and seventy patients were included and analyzed. One hundred and three patients were treated with the pigtail tube (82 patients were treated with a pigtail tube connected to a one-way-valve bag, and 21 with an underwater seal), and 67 patients were treated with the traditional chest tube. The extubation time, mean hospital stay, evacuation rate, and total cost were similar, without significant statistical difference. In the chest tube group (success rate, 78%), fifteen patients underwent surgical intervention due to delayed resolution, hemopneumothorax, and personal considerations; and in the pigtail group (success rate, 70%), thirty-one patients underwent other procedures for pneumothorax, including chest tube insertion and surgical intervention. This verifies our initial suspicion that the pigtail drainage system is effective but not superior to the chest tube system. Between the two subgroups using the pigtail drainage system (one with a one-way-valve bag and one with an underwater-sealed bottle), the extubation time, mean hospital stay, and evacuation rate were similar, but the total cost was higher in the underwater seal group. Therefore, when considering ambulatory ability and good patient compliance, pigtail tube drainage with a one-way-valve bag system can be considered the initial treatment of choice for spontaneous pneumothorax.

並列關鍵字

chest tube pigtail spontaneous pneumothorax

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