Comparison between Upper and Lower Chest Zone Drainage of Primary Spontaneous Pneumothorax by Ultrasound-guided Pigtail Catheter

比較超音波導引豬尾導管在上下胸域引流原發性自發性氣胸

蔡文凱(Wen-Kai Tsai) ； 陳偉(Wei Chen) ； 李仁智(Jen-Chih Lee) ； 杭良文(Liang-Wen Hang) ； 施純明(Chuen-Ming Shih) ； 徐武輝(Wu-Huei Hsu)

《Mid-Taiwan Journal of Medicine》 11卷2期 (2006/06) Pp. 90-96

https://doi.org/10.6558/MTJM.2006.11(2).3

摘要

Purpose. We have found that primary spontaneous pneumothorax (PSP) can be successfully managed with ultrasound-guided pigtail catheter placed in the lower chest zone. This study was to ascertain whether drainage of PSP from the lower chest zone is as effective as drainage from the upper chest zone.
Methods. This was a 6-year retrospective chart analysis of 150 consecutive patients who underwent pigtail drainage as initial treatment of first episode PSP. All enrolled patients underwent chest ultrasound before pigtail catheter insertion. Based on chest radiographs, we arbitrarily divided these patients into two groups according to the position of pigtail insertion. Pneumothorax was drained from the upper chest zone (UCZ) in 33 patients and from the lower chest zone (LCZ) in 117 patients. UCZ was defined as the upper half of the hemithorax and LCZ was defined as the lower half of the hemithorax.
Results. One-week success rates were obtained in 88 out of 117 patients (75.2%) in the LCZ group, and in 26 out of 33 patients (78.8%) in the UCZ group (p=0.67). Recurrence rates at 1-year follow-up were 22 out of 117 (18.8%) in the LCZ group, and 4 out of 33 (12.1%) in the UCZ group (p=0.37). Further analysis of length of hospital stay, duration of pigtail intubation and complication rate in both groups revealed no statistically significant difference between the two procedures (all p＞0.05).
Conclusions. The insertion site of ultrasound-guided pigtail catheter does not affect one-week success rate, one-year recurrence rate, complication or hospital stay in patients with PSP.

關鍵字

胸部超音波 ； 原發性自發性氣胸 ； 豬尾導管

並列摘要

Purpose. We have found that primary spontaneous pneumothorax (PSP) can be successfully managed with ultrasound-guided pigtail catheter placed in the lower chest zone. This study was to ascertain whether drainage of PSP from the lower chest zone is as effective as drainage from the upper chest zone.
Methods. This was a 6-year retrospective chart analysis of 150 consecutive patients who underwent pigtail drainage as initial treatment of first episode PSP. All enrolled patients underwent chest ultrasound before pigtail catheter insertion. Based on chest radiographs, we arbitrarily divided these patients into two groups according to the position of pigtail insertion. Pneumothorax was drained from the upper chest zone (UCZ) in 33 patients and from the lower chest zone (LCZ) in 117 patients. UCZ was defined as the upper half of the hemithorax and LCZ was defined as the lower half of the hemithorax.
Results. One-week success rates were obtained in 88 out of 117 patients (75.2%) in the LCZ group, and in 26 out of 33 patients (78.8%) in the UCZ group (p=0.67). Recurrence rates at 1-year follow-up were 22 out of 117 (18.8%) in the LCZ group, and 4 out of 33 (12.1%) in the UCZ group (p=0.37). Further analysis of length of hospital stay, duration of pigtail intubation and complication rate in both groups revealed no statistically significant difference between the two procedures (all p＞0.05).
Conclusions. The insertion site of ultrasound-guided pigtail catheter does not affect one-week success rate, one-year recurrence rate, complication or hospital stay in patients with PSP.

並列關鍵字

chest ultrasound ； pigtail catheter ； primary spontaneous pneumothorax