体位选择结合自体血胸腔注入治疗术后持续漏气伴肺复张不全前瞻性研究

A prospective study of position selection combined with autologous blood intrathoracic infusion in the treatment of postoperative persistent air leakage with an unexpanded lung

前瞻性研究2020年10月至2022年3月因自发性气胸或巨型肺大疱就诊于日照市中医医院行内科胸腔镜介入治疗、术后经胸腔闭式引流3 d仍持续漏气且行胸部CT提示肺复张不全或术后持续漏气经体位选择结合凝血酶胸腔注入(简称“体位加1.0”)干预失败,应用体位选择联合自体血(100 ml)及凝血酶(5000 U)胸腔注入(简称“体位加2.0”)治疗的17例患者资料。“体位加2.0”干预的成功率为16/17,复发率为3/17,4例患者出现发热,4例出现胸腔积液,1例发生脓胸,余无其他不良反应。本研究显示,对于内科胸腔镜治疗大疱性肺-胸膜疾病术后持续漏气并肺复张不全或“体位加1.0”干预失败者,“体位加2.0”干预安全、有效,且操作简单。

We prospectively studied 17 patients with spontaneous pneumothorax or giant emphysematous bulla at Rizhao Hospital of Traditional Chinese Medicine from October 2020 to March 2022.All patients underwent thoracoscopic interventional therapy,had experienced continued air leakage for 3 days with closed thoracic drainage postoperatively,had an unexpanded lung on CT,and/or failed to intervention with position selection combined with intra-pleural thrombin injection(referred to as"position plus1.0").They were all treated with position selection combined with autologous blood(100 ml)and thrombin(5000 U)intra-pleural injection(referred to as"position plus 2.0").The success rate of the"position plus 2.0"intervention was 16/17,and the recurrence rate was 3/17.There were four cases of fever,four cases of pleural effusion,one case of empyema,and no other adverse reactions.This study has shown that the"position plus 2.0"intervention is safe,effective,and simple for patient with persistent air leakage failed to intervention with"position plus 1.0"after thoracoscopic treatment of pulmonary and pleural diseases related to bulla.