CT引导下经皮穿刺注射硬化剂治疗肺大泡的临床应用

CT-guided percutaneous puncturing and injection of sclerosing agent for the treatment of lung bullae:its clinical application

目的探讨CT引导下经皮穿刺注射硬化剂治疗肺大泡的可行性、安全性及疗效。方法19例肺大泡患者，CT引导下经皮穿刺注射硬化剂聚桂醇，2～4d后再次在CT引导下抽出气体和渗出液，术后随访CT等检查评估患者临床症状改善情况。结果19例患者共22个肺大泡，手术成功率100％．其中18个肺大泡空腔完全消失，4个仅有少量气体残存，患者呼吸困难症状均得到明显改善或消失。术后3例患者出现少量气胸，2例患者诉胸部明显疼痛，均给予对症处理后好转。结论CT引导下经皮穿刺注射硬化剂治疗肺大泡疗效明确，创伤小，并发症少，费用低，痛苦少，值得推广。

Objective To evaluate the feasibility, safety and clinical effect of CT- guided percutaneous puncturing and injection of sclerosing agent in treating lung bullae. Methods CT- guided pereutaneous puncturing and injection of sclerosing agent （lauromaerogol） was carried out in 19 patients with lung bullae. Two to four days later, under CT guidance puncturing was performed again to draw out the air and exudates. After the treatment all the patients were followed up with CT scanning, and the improvement of clinical condition was evaluated. Results A total of 22 lung buUae were detected in 19 patients. Successful operation was obtained in all patients with a success rate of 100%. Of the 22 lung bullae, the bullous cavity completely disappeared in 18 and only small amount of residual air was detected in 4. Remarkable improvement or disappearance of dyspnea was seen in all patients. After the treatment, slight pneumothorax occurred in three patients and two patients complained of severe chest pain, which were relieved soon after symptomatic medication. Conclusion For the treatment of lung bullae, CT-guided percutaneous puncturing and injection of sclerosing agent is reliable, less- invasive and low- costing with fewer complications. Therefore, this technique should be recommended in clinical practice. （J Intervent Radiol, 2013, 22： 747- 749）