胸膜腔造影在自发性气胸诊断与治疗中的应用

Contrast Pleurography in the Diagnosis and Treatment of Spontaneous Pneumothorax

目的 探讨60％泛影葡胺胸膜腔造影在自发性气胸病因诊断与治疗中的应用价值。方法 共检查治疗33例(36侧)。16例有慢性气管炎病史,6例有肺结核史。胸膜腔内注入60％泛影葡胺30～40ml,透视观察并摄片。结果 单发性肺大泡19侧,多发者9侧。31侧显示脏层胸膜破口/大泡破口,分别表现为气泡溢出、少量造影剂进入大泡或小支气管和直接显示破口。除1例因气胸多次复发行手术治疗外,余32例随访1年无复发。结论 用60％泛影葡胺胸膜腔造影在自发性气胸诊断与治疗中应用安全、有效,不需另行制备硬化剂。

Objective To investigate the value of contrast Pleurography with 60% Gastrografin in the diagnosis and treatment of Spontaneous Pneumothorax. Methods 33 cases with spontaneous pneumothorax were collected and treated. 16 cases were suffered from chronic bronchitis,and 6 cases were suffered from pulmonary tuberculosis. 30-40ml 60% Gastrografin were injected into pleural cavity,and 5ml contrast medium in bullae puncturing,then observed carefully and took films under fluoroscopy. Results Single Pulmonary bullae were found in 19 sides,multiple in 9 sides,site of rupture of bullae in 31 sites. Contrast pleurography displayed that gas vacuole overflowed and a little of contrast medium flowed into bullae or small bronchi,and site of rupture of bullae. In this series pneumothorax were cured by way follow-up survey in 32 cases,recurred and operated on one. Conclusion Pleurography with 60% Gastrografin in the diagnosis and treatment of pulmonary bullae was safe and effective,and sclerotic agents were not prepared additionally.