Department of Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104, USA.
Ann Thorac Surg. 2011 Jan;91(1):270-3. doi: 10.1016/j.athoracsur.2010.07.093.
An endobronchial valve developed for treatment of severe emphysema has characteristics favorable for bronchoscopic treatment of air leaks. We present the results of a consecutive case series treating complex alveolopleural fistula with valves.
Patients with air leaks that persisted after treatment gave consent and compassionate use approval was obtained. Bronchoscopy with balloon occlusion was used to identify the airways to be treated. IBV Valves (Spiration, Redmond, WA) were placed after airway measurement.
During a 15-month period, 8 valve placement procedures were performed in 7 patients and all had improvement in the air leak. The median duration of air leakage was 4 weeks before and 1 day after treatment, with a mean of 4.5 days. Discharge within 2 to 3 days of the procedure occurred in 57% of the patients. A median of 3.5 valves (mode, 2.4) were used, and all valve removals were successful. There were no procedural or valve-related complications.
Removable endobronchial valves appear to be a safe and effective intervention for prolonged air leaks.
一种用于治疗严重肺气肿的支气管内瓣膜具有有利于支气管镜治疗气漏的特点。我们报告了一系列使用瓣膜治疗复杂肺泡-胸膜瘘的连续病例结果。
对治疗后仍持续存在空气漏的患者给予同意，并获得了同情使用批准。使用球囊阻塞支气管镜来识别需要治疗的气道。在气道测量后放置 IBV 瓣膜（Spiration，雷蒙德，华盛顿州）。
在 15 个月的时间里，7 名患者进行了 8 次瓣膜放置手术，所有患者的空气漏均得到改善。治疗前空气漏持续时间中位数为 4 周，治疗后 1 天，平均为 4.5 天。57%的患者在术后 2 至 3 天内出院。中位数使用 3.5 个瓣膜（模式，2.4），所有瓣膜均成功取出。无操作或瓣膜相关并发症。
可移除的支气管内瓣膜似乎是治疗长期空气漏的一种安全有效的干预措施。
