经胸膜腔内注射纤维蛋白封闭剂成功闭合支气管胸膜瘘：1例病例报告并文献复习
Successful closure of a bronchopleural fistula by intrapleural administration of fibrin sealant: a case report with review of literature.
作者信息
Shrestha Pranabh, Safdar Syed Aatif, Jawad Sami Abdul, Shaaban Hamid, Dieguez Javier, Elberaqdar Enas, Rai Srijana, Adelman Marc
机构信息
Department of Internal Medicine, Newark, New Jersey, USA ; Department of Pulmonary Medicine, Newark, New Jersey, USA.
Department of Internal Medicine, Newark, New Jersey, USA ; Department of Hematology and Oncology, St. Michael's Medical Center, Newark, New Jersey, USA.
出版信息
N Am J Med Sci. 2014 Sep;6(9):487-90. doi: 10.4103/1947-2714.141660.
CONTEXT
There are no established guidelines for the proper treatment of patients with bronchopleural fistulas (BPFs). Apart from attempts to close the fistula, emphasis of treatment and management is placed on preventive measures, early administration of antibiotics, drainage of the empyema and aggressive nutritional and rehabilitative support.
CASE REPORT
A 53-year-old male presented with nausea, vomiting, and dry cough with eventual respiratory failure. He was found to have an empyema of the left hemithorax which was managed with thoracostomy drainage and antibiotics. However, he had persistent air leak through the chest tube due to a BPF. Bronchoscopy failed to localize the involved segment. Application of fibrin glue through the chest tube succeeded in completely sealing the leak.
CONCLUSION
To our knowledge, this is the first case report in which fibrin glue was successfully used intrapleurally to close a BPF related to an empyema.
背景
目前尚无针对支气管胸膜瘘（BPF）患者的适当治疗的既定指南。除了尝试闭合瘘管外，治疗和管理的重点还在于预防措施、早期使用抗生素、脓胸引流以及积极的营养和康复支持。
病例报告
一名53岁男性出现恶心、呕吐和干咳，最终发展为呼吸衰竭。他被发现左半胸有脓胸，通过胸腔造口引流和抗生素进行治疗。然而，由于支气管胸膜瘘，他通过胸管持续漏气。支气管镜检查未能确定受累节段。通过胸管应用纤维蛋白胶成功完全封闭了漏气。
结论
据我们所知，这是首例通过胸腔内应用纤维蛋白胶成功闭合与脓胸相关的支气管胸膜瘘的病例报告。
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