Cordovilla Rosa, Torracchi Aldo Mateo, Novoa Nuria, Jiménez Marcelo, Aranda Jose Luis, Varela Gonzalo, Barrueco Miguel
Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España.
Servicio de Neumología, Hospital Universitario de Salamanca, Salamanca, España.
Arch Bronconeumol. 2015 Jan;51(1):10-5. doi: 10.1016/j.arbres.2014.04.007. Epub 2014 Nov 11.
Persistent air leak is frustrating for both patients and physicians, above all leaks with a high risk of surgery. Insertion of endobronchial valves could be an alternative to surgery. The aim of this study is to describe our experience in these valves and analyse their efficacy in a series of patients with persistent air leaks.
The valves are inserted by means of flexible bronchoscopy under conscious sedation and local anesthesia. A preliminary bronchoscopy identifies the air leak by bronchial occlusion using a balloon catheter. A successful outcome is defined as complete disappearance of the leak following removal of the chest drain, without the need for further surgery.
From November 2010 to December 2013, 8 patients with persistent air leaks were treated with endobronchial valves. The number of valves used ranged from 1 to 4 (median 2), with a median duration of air leak prior to placement of 15.5 days. There were no complications and the resolution of the leak was complete in 6 of 8 patients (75%). The median duration of drainage after insertion of the valves was 13 days and the median time to removal of 52.5 days.
Insertion of endobronchial valves is a safe and effective method for treating persistent air leaks, and a valid alternative to surgery.
持续性漏气对患者和医生来说都令人沮丧，尤其是那些具有高手术风险的漏气情况。支气管内瓣膜置入术可能是手术的一种替代方法。本研究的目的是描述我们在这些瓣膜方面的经验，并分析其在一系列持续性漏气患者中的疗效。
在清醒镇静和局部麻醉下，通过柔性支气管镜插入瓣膜。初步支气管镜检查使用球囊导管通过支气管阻塞来确定漏气情况。成功的结果定义为拔除胸腔引流管后漏气完全消失，且无需进一步手术。
从2010年11月至2013年12月，8例持续性漏气患者接受了支气管内瓣膜治疗。使用的瓣膜数量为1至4个（中位数为2个），置入前漏气的中位持续时间为15.5天。无并发症发生，8例患者中有6例（75%）漏气完全消失。瓣膜置入后引流的中位持续时间为13天，拔除的中位时间为52.5天。
支气管内瓣膜置入术是治疗持续性漏气的一种安全有效的方法，也是手术的一种有效替代方法。
