有色盐水定位气胸肺破裂口靶支气管(附23例临床分析)

Localization of the bronchus responsible for air leakage on pneumothorax by colored saline injection(Clinical analysis of 23 cases)

目的探讨亚甲蓝盐水定位气胸肺破裂口靶支气管的方法,并评价其效果及安全性。方法 23例难治性气胸患者,在纤维支气管镜直视下,气道内注射亚甲蓝盐水,定位气胸肺破裂口靶支气管,并行生物蛋白胶及α-氰基丙烯酸酯(OB胶)封堵术。结果 23例患者气胸靶支气管定位成功,平均时间(50.6±29.1)s,盐水平均用量(59.1±24.8)ml。定位中气道黏膜完整,呼吸循环功能稳定。蛋白胶封堵成功19例和OB胶4例;封堵后发热3例,剧烈咳嗽且胸腔出血各2例,肺不张和肺炎各1例。结论纤维支气管镜直视下,经导管气道内注射亚甲蓝盐水,是气胸靶支气管定位的一种简单、廉价、安全和有效的新方法。

【Objective】To evaluate the efficacy and safety of a new method to locate the responsible bronchus in 23 pneumothorax cases by colored saline. 【Methods】Of 23 cases, methylene blue saline was injected into the target bronchus to localize the position of the air leakage which guiding the occlusion with fibrin glue, or OB glue.【Results】All of 23 cases, bronchus responsible for air leakage had been successfully localized, the average time of locating（from the methylene blue saline injection to the leakage position fixing） was（50.6 ±29.1） s, the average amount of methylene blue saline was（59.1±24.8） ml/case. No mucosal injury and respiratory dysfunction took place during the operation. Fibrin glue occlusion was completed in 19 cases and OB glue in 4 cases. There were 3 fever cases, severe cough and thoracic bleeding in 2 cases each, pulmonary atelectasis in one case and pneumonia in one case.【Conclusion】Under the direct vision of bronchoscopy, it was a simple, cheap, safe and effective method to locate the responsible bronchus of pulmonary air leakage by injecting methylene blue saline into target bronchus.