Kanoh S, Kobayashi H, Motoyoshi K
Division of Pulmonary Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
Thorax. 2008 Jun;63(6):564-5. doi: 10.1136/thx.2007.087957.
Bronchoscopic treatment for emphysematous lung diseases has attracted clinical attention, and several different approaches are being investigated. We present a case of emphysematous bullae that was effectively treated with a newly developed bronchoscopic intervention, autologous blood injection. A 59-year-old man was referred to our institution with exertional dyspnoea. Chest CT showed emphysema and bullae with a diameter of 12 cm in the right upper lobe. Bronchoscopic treatment was introduced as an alternative to surgery. Autologous blood and fibrinogen solution were infused into bullae via the transbronchial catheter, under fluoroscopic guidance. Post-treatment CT showed marked contraction of bullae to a diameter of 3 cm, corresponding to a volume reduction of 800 ml on body plethysmography. A significant reduction in dyspnoea was also noted. This therapeutic approach is less invasive and may represent a good option for reducing lung volume.
支气管镜治疗肺气肿性肺疾病已引起临床关注，目前正在研究几种不同的方法。我们报告一例肺气肿性大疱患者，通过一种新开发的支气管镜干预措施——自体血注射，得到了有效治疗。一名59岁男性因劳力性呼吸困难转诊至我院。胸部CT显示肺气肿和右上叶直径为12 cm的大疱。支气管镜治疗作为手术的替代方法被采用。在荧光透视引导下，通过经支气管导管将自体血和纤维蛋白原溶液注入大疱。治疗后的CT显示大疱明显缩小至直径3 cm，根据体积描记法，体积减少了800 ml。同时还注意到呼吸困难明显减轻。这种治疗方法侵入性较小，可能是减少肺容积的一个好选择。
