Division of Respiratory Surgery, Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
Surg Today. 2011 Sep;41(9):1207-10. doi: 10.1007/s00595-010-4462-2. Epub 2011 Aug 26.
To investigate retrospectively the treatment strategies for chronic expanding hematoma (CEH) of the thorax.
We reviewed the medical records of six patients treated for CEH of the thorax at our institution between October 1996 and October 2006.
All of the patients had a history of thoracic surgery or tuberculosis with a latent period of 12-55 years before onset. One elderly patient with ischemic heart disease and in poor general health demonstrated a substantial improvement of symptoms after undergoing arterial embolization twice instead of surgery. The remaining five patients underwent either pleuropneumonectomy or a total capsule excision, following which their clinical condition improved remarkably. All six patients were discharged from the hospital. Arterial embolization was performed before surgery, and the amount of intraoperative bleeding ranged from 905 ml to 6,590 ml (average: 2,396 ml).
Chronic expanding hematoma of the thorax may occur after thoracic surgery and a tuberculosis infection; however, considering the risk of massive bleeding during surgery, the decision to perform surgery should be made with extreme care.
回顾性研究胸腔慢性扩展血肿（CEH）的治疗策略。
我们回顾了 1996 年 10 月至 2006 年 10 月期间在我院接受胸腔 CEH 治疗的 6 例患者的病历。
所有患者均有胸部手术或结核病病史，发病前潜伏期为 12-55 年。一位患有缺血性心脏病且身体状况不佳的老年患者在接受两次动脉栓塞治疗后，症状明显改善，而非手术治疗。其余 5 例患者行胸膜肺切除术或全囊切除术，术后临床症状明显改善。6 例患者均出院。手术前进行了动脉栓塞，术中出血量为 905ml 至 6590ml（平均：2396ml）。
胸腔慢性扩展血肿可能继发于胸部手术和结核感染；然而，考虑到手术中大量出血的风险，应慎重决定是否进行手术。
