Kato R, Kobayashi T, Watanabe M, Kawamura M, Kikuchi K, Kobayashi K, Ishihara T
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Thorac Cardiovasc Surg. 1992 Oct;40(5):292-6. doi: 10.1055/s-2007-1020167.
The pleural drain with persistent air leak in six selected patients after pulmonary surgery was clamped or removed without causing pulmonary collapse. In all the patients, air leak through the chest tube was present when speaking or coughing but not seen when breathing normally at rest or taking deep breaths. The fact that the chest tube could be removed in selected patients is explained by supposing the air leakage through an alveolopleural fistula is dependent on pressure difference between the alveoli and the pleural cavity, and this was confirmed in a rethoracotomy case for persistent air leak. Removal of the chest tube following the above-mentioned rationale would reduce the number of rethoracotomy cases for air leak and facilitate early removal of the chest tube in some patients.
在六例肺部手术后出现持续性漏气的特定患者中,胸腔引流管被夹闭或拔除,且未导致肺萎陷。在所有这些患者中,说话或咳嗽时胸腔引流管有漏气,但在静息时正常呼吸或深呼吸时未见漏气。对于特定患者能够拔除胸腔引流管这一情况,其解释是假设通过肺泡胸膜瘘的漏气取决于肺泡与胸膜腔之间的压力差,这在一例因持续性漏气而行再次开胸手术的病例中得到了证实。按照上述原理拔除胸腔引流管将减少因漏气而行再次开胸手术的病例数量,并有助于部分患者早期拔除胸腔引流管。