Abstract：
OBJECTIVE: In patients with thoracic injuries, tube thoracostomy is routinely employed. There is disagreement over which manner of tube withdrawal is best, the latter phases of expiration or inspiration. Considering several earlier investigations\' inconsistent findings, their comparative effectiveness is still up for debate. In light of this, we carried out a systematic analysis of studies contrasting the withdrawal of thoracostomy tubes during the latter stages of expiration versus inspiration for traumatic chest injuries. Analyzed outcomes are recurrent pneumothoraces, reinsertion of the thoracostomy tube, and hospital stay.
METHODS: We looked for papers comparing the withdrawal of the thoracostomy tube during the last stages of expiration and inspiration for the management of thoracic injuries on Embase, Pubmed, Cochrane Library and Google Scholar. Review Manager was used to determine mean differences (MD) and risk ratios (RR) using a 95% confidence interval (CI).
RESULTS: The primary outcomes showed no significant difference between the inspiration and expiration groups: recurrent pneumothorax (RR 1.27, 95% CI 0.83-1.93, P 0.28) and thoracostomy tube reinsertion (OR: 1.84, CI 0.50-6.86, P 0.36, I2 5%). However, the duration of hospital stay was significantly lower in patients in whom the thoracostomy tube was removed at the end of inspiration (RR 1.8, 95% CI 1.49-2.11, P < 0.00001, I2 0%). The implications of these findings warrant cautious interpretation, accounting for potential confounding factors and inherent limitations that may shape their significance.
CONCLUSIONS: The thoracostomy tube can be removed during both the end-expiratory and end-inspiratory stages of respiration with no appreciable difference. Nevertheless, caution should be exercised when ascertaining the implications of these findings, taking into account the potential limitations and confounding variables that may exert influence upon the outcomes.
METHODS: We looked for papers comparing the withdrawal of the thoracostomy tube during the last stages of expiration and inspiration for the management of thoracic injuries on Embase, Pubmed, Cochrane Library and Google Scholar. Review Manager was used to determine mean differences (MD) and risk ratios (RR) using a 95% confidence interval (CI).
RESULTS: The primary outcomes showed no significant difference between the inspiration and expiration groups: recurrent pneumothorax (RR 1.27, 95% CI 0.83-1.93, P 0.28) and thoracostomy tube reinsertion (OR: 1.84, CI 0.50-6.86, P 0.36, I2 5%). However, the duration of hospital stay was significantly lower in patients in whom the thoracostomy tube was removed at the end of inspiration (RR 1.8, 95% CI 1.49-2.11, P < 0.00001, I2 0%). The implications of these findings warrant cautious interpretation, accounting for potential confounding factors and inherent limitations that may shape their significance.
CONCLUSIONS: The thoracostomy tube can be removed during both the end-expiratory and end-inspiratory stages of respiration with no appreciable difference. Nevertheless, caution should be exercised when ascertaining the implications of these findings, taking into account the potential limitations and confounding variables that may exert influence upon the outcomes.
摘要：
目的：胸部损伤患者，常规采用管状胸廓造口术。对于哪种方式最好的取管方式存在分歧，过期或吸气的后期阶段。考虑到先前的几次调查结果不一致，它们的相对有效性仍有待辩论。鉴于此,我们对研究进行了系统分析，对比了在呼气后期和吸气阶段对创伤性胸部损伤的胸廓造口管的退出。分析的结果是复发性气胸，重新插入胸腔造口管，住院。
方法：我们寻找比较在呼气的最后阶段和灵感的文献，以治疗Embase上的胸部损伤，Pubmed,科克伦图书馆和谷歌学者。使用ReviewManager以95%置信区间(CI)确定平均差异(MD)和风险比(RR)。
结果：主要结果显示吸气组和呼气组之间没有显着差异：复发性气胸（RR1.27，95％CI0.83-1.93，P0.28）和胸廓造口管再插入（OR：1.84，CI0.50-6.86，P0.36，I25％）。然而,在吸气结束时拔除胸廓造口管的患者的住院时间明显较短(RR1.8,95%CI1.49-2.11,P<0.00001,I20%).这些发现的含义值得谨慎解释，考虑可能影响其重要性的潜在混杂因素和固有限制。
结论：在呼气末和吸气末呼吸阶段均可取出胸廓造口管，但无明显差异。然而，在确定这些发现的含义时应谨慎行事，考虑到可能对结果产生影响的潜在限制和混杂变量。
方法：我们寻找比较在呼气的最后阶段和灵感的文献，以治疗Embase上的胸部损伤，Pubmed,科克伦图书馆和谷歌学者。使用ReviewManager以95%置信区间(CI)确定平均差异(MD)和风险比(RR)。
结果：主要结果显示吸气组和呼气组之间没有显着差异：复发性气胸（RR1.27，95％CI0.83-1.93，P0.28）和胸廓造口管再插入（OR：1.84，CI0.50-6.86，P0.36，I25％）。然而,在吸气结束时拔除胸廓造口管的患者的住院时间明显较短(RR1.8,95%CI1.49-2.11,P<0.00001,I20%).这些发现的含义值得谨慎解释，考虑可能影响其重要性的潜在混杂因素和固有限制。
结论：在呼气末和吸气末呼吸阶段均可取出胸廓造口管，但无明显差异。然而，在确定这些发现的含义时应谨慎行事，考虑到可能对结果产生影响的潜在限制和混杂变量。
