肺切除术后并发症的处理：持续性漏气和支气管胸膜瘘。
Management of Complications After Lung Resection: Prolonged Air Leak and Bronchopleural Fistula.
机构信息
Section of General Thoracic Surgery, Department of Surgery, University of California, Davis Health, 2335 Stockton Boulevard, 6th Floor North Addition Office Building, Sacramento, CA 95817, USA. Electronic address: https://twitter.com/JamesClarkMD.
Section of General Thoracic Surgery, Department of Surgery, University of California, Davis Health, 2335 Stockton Boulevard, 6th Floor North Addition Office Building, Sacramento, CA 95817, USA. Electronic address: https://twitter.com/DavidCookeMD.
出版信息
Thorac Surg Clin. 2020 Aug;30(3):347-358. doi: 10.1016/j.thorsurg.2020.04.008. Epub 2020 Apr 17.
Abstract
Prolonged air leak or alveolar-pleural fistula is common after lung resection and can usually be managed with continued pleural drainage until resolution. Further management options include blood patch administration, chemical pleurodesis, and 1-way endobronchial valve placement. Bronchopleural fistula is rare but is associated with high mortality, often caused by development of concomitant empyema. Bronchopleural fistula should be confirmed with bronchoscopy, which may allow bronchoscopic intervention; however, transthoracic stump revision or window thoracostomy may be required.
摘要
肺切除术后常见持续性漏气或肺泡-胸膜瘘，通常可通过持续胸膜引流直至痊愈来处理。进一步的治疗选择包括血补丁给药、化学胸膜固定术和单向支气管内瓣膜放置。支气管胸膜瘘很少见，但与高死亡率相关，通常由并发脓胸引起。支气管胸膜瘘应通过支气管镜检查来确认，支气管镜检查可能允许进行支气管镜介入；然而，可能需要经胸残端修正或胸腔开窗术。
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