Intrapleural streptokinase with pigtail catheter drainage versus medical thoracoscopy in complicated parapneumonic effusion

IF 0.2 Q4 RESPIRATORY SYSTEM

Egyptian Journal of Chest Diseases and Tuberculosis Pub Date : 2023-01-01 DOI:10.4103/ecdt.ecdt_3_23

Mervat A Abou Ismail, Ahmed Y Gad, Hatem A Elmallawany, Hany H Moussa

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Abstract

Abstract Context Parapneumonic effusion and empyema are commonly encountered by the pulmonologist. The decision regarding management is still challenging. Aim To compare outcomes of intrapleural streptokinase with pigtail catheter drainage versus medical thoracoscopy in complicated parapneumonic effusion. Methods and material Forty patients with complicated parapneumonic effusion were randomly allocated to one of two groups. Twenty patients underwent streptokinase intrapleural instillation via pigtail catheter. The other twenty patients underwent medical thoracoscopy. Results Intrapleural streptokinase instillation procedure was significantly shorter duration (12.80 ± 3.05 min) than medical thoracoscopy procedure (25.26 ± 4.66 min). However medical thoracoscopy showed a significant less days required to remove the drainage system (5.80 ± 1.70 days) versus intrapleural streptokinase instillation procedure (9.40 ± 3.91 days). Both groups had no significant complications. Lung expansion was achieved in 90% of patients treated with intrapleural streptokinase instillation and in 95% of patients treated with a medical thoracoscopy technique, with no statistically significant difference between the two groups. Conclusions Treatment of complicated parapneumonic effusions is undeniably interdisciplinary. Both intrapleural streptokinase with pigtail catheter drainage and medical thoracoscopy are safe and improve outcomes in complicated parapneumonic effusion. Medical thoracoscopy has an advantage of fewer days required for tube withdrawal. Pigtail insertion has an advantage of shorter procedure time compared to medical thoracoscopy

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胸膜内链激酶联合猪尾导管引流与内科胸腔镜治疗复杂性肺旁积液的比较

摘要背景:肺旁积液和肺气肿是肺科医生经常遇到的问题。关于管理的决定仍然具有挑战性。目的比较猪尾导管胸膜内链激酶引流与内科胸腔镜治疗复杂性肺旁积液的疗效。方法与材料将40例合并肺旁积液患者随机分为两组。20例患者经猪尾导管胸膜内注入链激酶。另外20名患者接受了内科胸腔镜检查。结果胸膜内链激酶滴注时间(12.80±3.05 min)明显短于内科胸腔镜(25.26±4.66 min)。然而，医学胸腔镜显示取出引流系统所需的时间(5.80±1.70天)明显少于胸膜内注入链激酶所需的时间(9.40±3.91天)。两组均无明显并发症。胸膜内注入链激酶治疗的患者肺扩张率为90%，内科胸腔镜治疗的患者肺扩张率为95%，两组间无统计学差异。结论复杂肺旁积液的治疗是一门跨学科的学科。胸膜内链激酶联合猪尾导管引流和内科胸腔镜治疗复杂性肺旁积液是安全的，并能改善预后。医学胸腔镜的优点是拔管所需的时间更短。与内科胸腔镜相比，猪尾插入术具有手术时间短的优点

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来源期刊

Egyptian Journal of Chest Diseases and Tuberculosis RESPIRATORY SYSTEM-

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审稿时长

22 weeks

期刊介绍： The journal will cover technical and clinical studies related to health, ethical and social issues in field of The Egyptian Journal of Chest Diseases and Tuberculosis aims to publish and inform readers and all chest physicians of the progress in medical research concerning all aspect of chest diseases. Publications include original articles review articles, editorials, case studies and reports which are relevant to chest diseases. The Journal also aims to highlight recent updates in chest medicine. . Articles with clinical interest and implications will be given preference.

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