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Therapeutic effects of thoracoscopic ultrasound-guided pigtail drainage for tuberculous pleural effusion in elderly patients / 中华老年医学杂志
Chinese Journal of Geriatrics ; (12): 428-432, 2022.
Article in Chinese | WPRIM | ID: wpr-933099
ABSTRACT

Objective:

To investigate the therapeutic effects of ultrasound-guided pigtail drainage under thoracoscopy in elderly patients with tuberculous pleural effusion.

Methods:

Elderly patients with tuberculous pleural effusion treated at Zhengzhou Sixth People's Hospital between April 2018 and May 2020 were selected.With a method using odd and even numbers, 100 elderly patients with tuberculous pleural effusion were randomly divided into a study group(odd numbers)and a conventional treatment group(even numbers), with 50 cases in each group.All patients received ultrasound-guided thoracoscopy to remove pleural effusion.The conventional treatment group received regular thoracic drainage catheters and the study group received pigtail catheters for drainage.Drainage was stopped after the patient was extubated.The levels of programmed cell death 1(PD-1), programmed death-ligand 1(PD-L1)and PD-1/PD-L1 in peripheral blood were detected and compared before and after catheterization; Values of clinical indicators including drainage volume, catheter retention time, length of hospitalization and complications during catheter drainage for the two groups were recorded.

Results:

After extubation, the levels of PD-1, PD-L1 and PD-1/PD-L1 in peripheral blood for both groups decreased, compared with pre-catheterization levels, with the study group having lower levels[(31.95±10.41)ng/L, (26.14±1.03)ng/L, (1.22±0.12)ng/L]than the conventional treatment group[(43.31±12.03)ng/L, (30.62±1.57)ng/L, (1.41±0.63)ng/L]( t=5.049, 16.871, 2.095, P<0.001, 0.039).The study group had a catheter retention time of(15.43±3.12)d and a length of hospitalization of(7.36±2.95)d, shorter than(11.32±3.87)d and(22.15±6.98)d in the conventional treatment group( t=5.754, 6.215, both P<0.001), but there was no statistical significant difference in drainage volume between the two groups( P>0.05).The incidence of drainage catheter falling out and catheter obstruction in the study group was lower than in the conventional treatment group[2.00%(1/50) vs.16.00%(8/50), 0.00%(0/50) vs.18.00%(9/50)]( χ2=4.396, 7.814, P=0.036, 0.005), and there was no statistical significant difference in the incidence of mediastinal shifting, subcutaneous emphysema, intrathoracic infections or hemothorax between the two groups(all P>0.05).

Conclusions:

Thoracoscopic ultrasound-guided pigtail catheter drainage for the treatment of elderly patients with tuberculous pleural effusion is clearly effective and may help to reduce the level of PD-1/PD-L1 in peripheral blood, shorten the time of catheter drainage and decrease some complications for patients.

Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Geriatrics Year: 2022 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Language: Chinese Journal: Chinese Journal of Geriatrics Year: 2022 Type: Article