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经支气管超声引导下经支气管针吸活检术治疗纵隔脓肿的风险与获益

Risks and benefits in treatment of mediastinal abscess by endobronchial ultrasound-guided transbronchial needle aspiration.

作者信息

Tian Lei, Krimsky William S, Wu Qingchen, Sun Jiayuan

机构信息

Departments of Endoscopy and Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

Department of Thoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Clin Respir J. 2017 Jul;11(4):448-452. doi: 10.1111/crj.12357. Epub 2015 Sep 24.

Abstract

INTRODUCTION

Mediastinal abscess is a fatal condition, treatment of mediastinal abscess is with antibiotics and sometimes surgery for debridement and drainage. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a safe assessment and candidate treatment method of mediastinal lesions.

OBJECTIVES

This study aimed to HYPERLINK "javascript:void(0);" discuss risks and benefits in treatment of mediastinal abscess by EBUS-TBNA.

METHODS

We noticed a 56-year-old man with developed bilateral pneumonia and sepsis after puncture of mediastinal abscess by EBUS-TBNA. The patient was successfully treated with a combination of systemic anti-infection treatment and intracavitary administration of antibiotics, antifungal and repeated drainage and lavage via EBUS-TBNA, in 1 year follow-up without recurrence.

RESULTS

This study indicated infection spread risk of mediastinal abscess after EBUS-TBNA, and mediastinal abscess was successfully cured by combination of systemic anti-infection and local intervention through EBUS-TBNA.

CONCLUSION

EBUS-TBNA is a potential effective minimally invasive treatment for mediastinal abscess, and it is necessary to be aware of clinical complications after puncture of mediastinal infectious lesions by EBUS-TBNA.

摘要

引言

纵隔脓肿是一种致命疾病,纵隔脓肿的治疗方法是使用抗生素,有时还需要进行手术清创和引流。支气管内超声引导下经支气管针吸活检术(EBUS-TBNA)是一种安全的纵隔病变评估及备选治疗方法。

目的

本研究旨在探讨EBUS-TBNA治疗纵隔脓肿的风险和益处。

方法

我们注意到一名56岁男性在接受EBUS-TBNA穿刺纵隔脓肿后出现双侧肺炎和败血症。该患者通过全身抗感染治疗与经EBUS-TBNA进行腔内抗生素、抗真菌药物给药及反复引流和灌洗相结合的方法成功治愈,随访1年无复发。

结果

本研究表明EBUS-TBNA术后纵隔脓肿存在感染扩散风险,且通过全身抗感染与经EBUS-TBNA进行局部干预相结合的方法成功治愈了纵隔脓肿。

结论

EBUS-TBNA是一种潜在有效的纵隔脓肿微创治疗方法,有必要了解EBUS-TBNA穿刺纵隔感染性病变后的临床并发症。

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