Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, SW, Rochester, MN 55905, USA.
J Pediatr Surg. 2013 Sep;48(9):1862-6. doi: 10.1016/j.jpedsurg.2012.12.040.
Persistent air leak (PAL) is associated with increased morbidity. Standard treatment of PAL includes chemical or mechanical pleurodesis. Long-term impact of these interventions is not known in the pediatric population. Autologous blood patch (ABP) offers a novel treatment option. We report our experience with autologous blood patch to successfully treat PAL in eight children.
Children with PAL were treated with ABP. A fresh whole blood sample was obtained from each patient and injected via their pre-existing chest tube. Volume of blood injected, time to cessation of air leak, time to chest tube removal, outcomes and complications were reviewed.
Eight children aged 2 months to 18 years underwent ABP. Three children had immediate seal of air leak, while two patients sealed after 1 and 2 days. Three patients required a second ABP, after which they had immediate seal of air leak. Chest tubes were removed within 2-3 days in 7 cases. One child developed an asymptomatic pneumothorax and required 8 days for radiographic resolution.
ABP appears to be a safe and effective treatment option for PAL in children. ABP offers an inexpensive, easy to perform technique and avoids use of toxic chemicals for pleurodesis in pediatric patients.
持续性气胸（PAL）与发病率增加有关。PAL 的标准治疗包括化学或机械性胸膜固定术。这些干预措施对儿科人群的长期影响尚不清楚。自体血贴（ABP）提供了一种新的治疗选择。我们报告了使用自体血贴成功治疗 8 例儿童 PAL 的经验。
采用 ABP 治疗 PAL 患儿。从每位患者中采集新鲜全血样本，并通过其预先存在的胸腔引流管注入。回顾了注射的血液量、气胸停止的时间、胸腔引流管拔除的时间、结果和并发症。
8 例 2 个月至 18 岁的儿童接受了 ABP 治疗。3 例患儿气胸立即封闭，2 例患儿 1 天和 2 天后封闭。3 例患儿需要第二次 ABP，之后立即封闭气胸。7 例患儿在 2-3 天内拔除胸腔引流管。1 例患儿出现无症状气胸，需要 8 天才能影像学缓解。
ABP 似乎是一种安全有效的治疗儿童 PAL 的选择。ABP 提供了一种廉价、易于实施的技术，并避免了在儿科患者中使用有毒化学物质进行胸膜固定术。
