支气管镜下自体血封堵术治疗难治性气胸1例  

A case of refractory pneumothorax treated by autologous blood occlusion surgery under bronchoscope

作　　者：黄婷苑 李文新[1] 何桂媛 曾玲 彭倩茹 曾凡军[1] HUANG Tingyuan;LI Wenxin;HE Guiyuan;ZENG Ling;PENG Qianru;ZENG Fanjun(Department of Respiratory and Critical Care Medicine,the First Clinical Medical College of China Three Gorges University,Yichang Central People’s Hospital,Hubei,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院,宜昌市中心人民医院呼吸与危重症医学科,湖北宜昌443003

出　　处：《中国医药科学》2024年第6期194-198,共5页China Medicine And Pharmacy

基　　金：湖北省宜昌市医疗卫生研究项目(A23-1-003)。

摘　　要：难治性气胸是指自发性气胸患者经胸腔穿刺引流后仍持续性漏气,其治疗手段有限。目前内科治疗难治性气胸主要有胸腔穿刺抽气、置管引流与胸膜固定术三种方法,外科治疗主要以胸腔镜手术或开胸手术为主。随着支气管镜介入诊疗的快速发展,选择性支气管封堵术与自体血封堵术因其创伤小、安全性高、疗效好等优点,为基础疾病多、心肺功能差、主观意愿不接受或不能耐受外科手术的难治性气胸患者带来了新的治疗方法。本文报道1例50岁中年男性患者,因反复气胸多次行胸腔闭式引流术与胸膜固定术,治疗效果不理想,症状反复,经采用支气管镜下球囊探查定位与自体血封堵的治疗方法后,患者气胸吸收,得到有效的治疗。Refractory pneumothorax means that patients with spontaneous pneumothorax continue to leak after thoracic puncture and drainage,and the treatment methods are limited.At present,there are three main methods for medical treatment of refractory pneumothorax,which are thoracic puncture and aspiration,catheter drainage and pleurodesis surgery.Thoracoscopic surgery or thoracotomy is the main surgical treatment.With the rapid development of bronchoscopic interventional diagnosis and treatment,selective bronchial occlusion surgery and autologous blood occlusion surgery have brought new treatment methods to patients with refractory pneumothorax who have many underlying diseases,poor cardiopulmonary functions and subjective will not accept or tolerate surgery because of their advantages of less trauma,high safety and good therapeutic efficacy.A case of 50-year-old middle-aged male patient undergoing closed thoracic drainage and pleurodesis for repeated pneumothorax is reported in this paper.The therapeutic efficacy is not satisfactory and the symptoms are repeated.After the treatment method of balloon exploration and positioning,and autologous blood occlusion surgery under bronchoscope,the patient’s pneumothorax is absorbed and effectively cured after operation.

关 键 词：选择性支气管封堵术 自体血封堵术 难治性气胸 球囊探查 

分 类 号：R655[医药卫生—外科学]