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標題: Secondary spontaneous pneumothorax: which associated conditions benefit from pigtail catheter treatment?
作者: Chen, C.H.
Liao, W.C.
Liu, Y.H.
Chen, W.C.
Hsia, T.C.
Hsu, W.H.
Shih, C.M.
Tu, C.Y.
關鍵字: pneumocystis-carinii-pneumonia;chest-tube;bronchopleural fistula;drainage;management;epidemiology;tuberculosis;bore
Project: American Journal of Emergency Medicine
期刊/報告no:: American Journal of Emergency Medicine, Volume 30, Issue 1, Page(s) 45-50.
Objective: The study aimed to assess the clinical efficacy of pigtail catheter drainage for patients with a first episode of secondary spontaneous pneumothorax (SSP) and different associated conditions. Methods: We retrospectively reviewed the records of patients with SSP who received pigtail catheter drainage as their initial management between July 2002 and October 2009. A total of 168 patients were included in the analysis; 144 (86%) males and 24 (14%) females with a mean age of 60.3 +/- 18.3 years (range, 17-91 years). Data regarding demographic characteristics, pneumothorax size, complications, treatments, length of hospital stay, and associated conditions were analyzed. Results: In total, 118 (70%) patients were successfully treated with pigtail catheter drainage, and 50 (30%) patients required further management. Chronic obstructive lung disease was the most common underlying disease (57% of cases). Secondary spontaneous pneumothorax associated with infectious diseases had a higher rate of treatment failure than SSP associated with obstructive lung conditions (19/38 [50%] successful vs 78/104 [75%] successful, P = .004) and malignancy (19/38 [50%] successful vs 13/16 [81%] successful, P = .021). Moreover, patients with SSP associated with infectious diseases had a longer length of hospital stay than those with obstructive lung conditions (23.8 vs 14.5 days, P = .003) and malignancy (23.8 vs 12.1 days, P = .017). No complications were associated with pigtail catheter drainage. Conclusions: A higher rate of treatment failure was noted in SSP patients with infectious diseases; thus, pigtail catheter drainage is appropriate as an initial management for patients with SSPs associated with obstructive lung conditions and malignancy. (C) 2012 Elsevier Inc. All rights reserved.
ISSN: 0735-6757
DOI: 10.1016/j.ajem.2010.09.014
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