Altree Thomas James, Jersmann Hubertus, Nguyen Phan
Department of Thoracic Medicine Royal Adelaide Hospital Adelaide South Australia Australia.
Respirol Case Rep. 2018 Sep 14;6(8):e00368. doi: 10.1002/rcr2.368. eCollection 2018 Nov.
A 62-year old man with severe chronic obstructive pulmonary disease developed a persistent air leak from an iatrogenic pneumothorax following Computed Tomography-guided core biopsy of a pulmonary nodule. The pneumothorax was treated with an 8.5F intercostal catheter, which was then replaced by a 28F thoracostomy tube after development of significant subcutaneous emphysema and a tension pneumothorax. The air leak showed no improvement until endobronchial valve (EBV) insertion guided by objective flow data from a digital drainage system (DDS). The air leak subsequently reduced with -20 cmHO suction from the DDS, and the thoracostomy tube was removed once the objective measured flow rate had sufficiently diminished. The combination of EBV insertion and suction from the DDS successfully treated the persistent air leak, with timing of thoracostomy tube removal guided by DDS flow data.
一名62岁患有严重慢性阻塞性肺疾病的男性，在计算机断层扫描引导下对肺部结节进行经皮肺穿刺活检后，发生医源性气胸并出现持续漏气。气胸最初采用8.5F肋间导管治疗，在出现明显皮下气肿和张力性气胸后，更换为28F胸管。在数字引流系统（DDS）客观流量数据引导下插入支气管内瓣膜（EBV）之前，漏气情况一直未改善。随后，通过DDS进行-20 cmH₂O的负压吸引，漏气量减少，一旦客观测量的流速充分降低，即拔除胸管。EBV插入与DDS负压吸引相结合成功治疗了持续漏气，并根据DDS流量数据指导胸管拔除时机。
