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支气管内瓣膜在肺部肿瘤热消融术后治疗支气管胸膜瘘中的应用。

Use of endobronchial valves for the treatment of bronchopleural fistulas after thermal ablation of lung neoplasms.

机构信息

Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.

出版信息

J Vasc Interv Radiol. 2012 Sep;23(9):1236-40. doi: 10.1016/j.jvir.2012.06.009.

Abstract

Persistent air leaks resulting from bronchopleural fistulas (BPFs) are a rare but serious side effect of thermal ablation. Traditionally, BPFs are treated with surgery; however, patients receiving ablation are often poor surgical candidates and require minimally invasive treatment. The present report describes four cases of BPFs following ablation, which were treated with endobronchial valves (EBVs). In three of the four patients, the pneumothoraces resolved after valve placement. One patient required further treatment with pleurodesis. EBVs can selectively block inspiratory airflow while allowing expiratory flow with drainage of air and secretions. In select patients, EBVs are a viable treatment option for BPFs.

摘要

支气管胸膜瘘(BPF)导致的持续性空气漏是热消融的一种罕见但严重的副作用。传统上,BPF 采用手术治疗;然而,接受消融的患者往往不适合手术,需要微创治疗。本报告描述了 4 例消融后发生的 BPF 病例,这些病例采用了支气管内覆膜支架(EBV)治疗。在这 4 例患者中,有 3 例在放置支架后气胸得到缓解。1 例患者需要进一步进行胸膜固定术。EBV 可以选择性地阻断吸气气流,同时允许呼气气流通过引流空气和分泌物。在选择的患者中,EBV 是治疗 BPF 的一种可行的治疗选择。

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