支气管镜胶水封堵术治疗肺移植术后支气管胸膜瘘

Bronchoscopic gluing for post-lung-transplant bronchopleural fistula.

作者信息

Chang Chin-Chih, Hsu Hsao-Hsun, Kuo Shuenn-Wen, Lee Yung-Chie

机构信息

Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Chung-Shan S. Rd, Taipei, Taiwan.

出版信息

Eur J Cardiothorac Surg. 2007 Feb;31(2):328-30. doi: 10.1016/j.ejcts.2006.11.002. Epub 2006 Dec 1.

DOI:10.1016/j.ejcts.2006.11.002

PMID:17141517

Abstract

A 44-year-old female patient diagnosed as pulmonary lymphangioleiomyomatosis with respiratory failure underwent bilateral sequential lung transplantation using an entire left lung and a post-lower-lobectomy right lung due to pneumonia. Persistent air leakage during cough was noted and bronchoscopy 12 days after transplantation demonstrated post-lobectomy bronchial stump dehiscence with a large bronchopleural fistula. We applied twice tissue glue instillation on the dehiscent bronchial stump through flexible bronchoscopy. The air leak improved and the patient was discharged 3 months after transplantation uneventfully. Two months after discharge, bronchoscopy showed complete healing of the dehiscent bronchial stump. Now, she lives independently without oxygen support.

摘要

一名44岁被诊断为肺淋巴管平滑肌瘤病并伴有呼吸衰竭的女性患者，因肺炎接受了双侧序贯肺移植，使用了整个左肺和右下肺叶切除术后的右肺。移植后12天，患者咳嗽时持续漏气，支气管镜检查显示肺叶切除术后支气管残端裂开并伴有巨大支气管胸膜瘘。我们通过可弯曲支气管镜对裂开的支气管残端进行了两次组织胶水灌注。漏气情况得到改善，患者在移植后3个月顺利出院。出院两个月后，支气管镜检查显示裂开的支气管残端完全愈合。现在，她无需氧气支持能够独立生活。