Bazarbachi T, Ghantous W, Daher M, Smayra T, Riachy M, Chelala D, Tabet G
Service de Pneumologie et de réanimation médicale, Hôtel-Dieu de France, Beyrouth, Liban.
Rev Mal Respir. 2009 Nov;26(9):985-8. doi: 10.1016/s0761-8425(09)73334-0.
Massive haemothorax is a relatively rare complication of thoracocentesis or the placement of tube thoracostomy. It is principally caused by intercostal vessel injury. The therapeutic approach consists in pleural drainage and sometimes thoracotomy for haemostasis.
We describe a frail 72 year old patient, who developed a massive haemothorax occurring after a tube thoracostomy placing, persisting despite second pleural drainage, and complicated by deep haemodynamic shock. He was considered to have a very high risk of mortality if surgery was undertaken. Haemorrhage was totally stopped after intercostal instillation of lidocaïne-adrenaline.
This case report suggests a role for pleural vasoconstrictor injection as initial treatment in case of persistent pleural haemorrhage caused by intercostal vessel injury.
大量血胸是胸腔穿刺术或胸腔闭式引流置管相对罕见的并发症。其主要由肋间血管损伤引起。治疗方法包括胸腔引流，有时需开胸止血。
我们描述了一名72岁体弱患者，在胸腔闭式引流置管后发生大量血胸，尽管进行了第二次胸腔引流仍持续存在，并伴有严重的血流动力学休克。如果进行手术，他被认为有很高的死亡风险。肋间注射利多卡因-肾上腺素后出血完全停止。
本病例报告表明，对于肋间血管损伤导致的持续性胸腔出血，胸膜血管收缩剂注射可作为初始治疗方法。
