支气管球囊定位联合自体血支气管封堵术治疗难治性气胸

Bronchial intractable pneumothorax balloon positioning combined with autologous blood bronchial occlusion in the therapy of intractable pneumothorax

目的：探讨支气管球囊定位联合自体血支气管封堵术治疗难治性气胸的治疗效果及安全性。方法以36例难治性自发性气胸患者为研究对象，在支气管镜检查的基础上行支气管球囊定位联合自体血支气管封堵术治疗，观察疗效和不良反应，随访半年。结果36例难治性自发性气胸患者中，经球囊定位成功患者30例（83．33％），6例未定位成功的患者继续予以留置胸腔闭式引流保守治疗；定位成功的30例患者行自体血支气管封堵术，共24例（80．0％）患者成功减少气泡逸出；6例患者复发，继续予以留置胸腔闭式引流保守治疗。手术过程所有患者均可耐受，成功率66．7％。6例患者在封堵术3 d 后出现低热，余无明显并发症。封堵成功病例随访半年后均无复发。结论支气管球囊定位联合自体血支气管封堵术治疗难治性气胸定位准确、封堵成功率高，安全、有效，值得在临床上推广应用。

Objective To investigate the effect and safety of bronchial balloon positioning combined with autologous blood bronchial occlusion in the treatment of intractable pneumothorax.Methods 36 cases of hospitalized patients with refractory spontaneous were collected as the research object,based on the bronchial balloon positioned upstream bronchoscopy combined with autologous blood bronchial occlusion therapy.The efficacy and adverse reac-tions were followed up for one year.Results In the 36 cases of spontaneous pneumothorax in patients with refractory, 30 patients were successfully positioning balloon （83.33%）,6 cases of patients who were not successfully positio-ning,were continued with conservative treatment of indwelling thoracic drainage.In 30 patients underwent successful positioning,autologous blood bronchial occlusion were used,and a total of 24 cases （80.0%）patients successfully reduced bubbles escape;6 patients relapsed,who were continued to retainthoracic drainage conservative treatment. Conclusion Bronchial balloon positioning combined with autologous blood bronchial occlusion in the treatment of intractable pneumothorax has accurate positioning and high blocking success rate,and also is safe and effective.It is worth promoting in clinical practice.