Department of Pulmonology, University Hospital of Udine (ASUFC), Udine.
Department of Pulmonology; Department of Infectious Disease, University Hospital of Udine (ASUFC), Udine.
Monaldi Arch Chest Dis. 2021 Sep 28;92(1). doi: 10.4081/monaldi.2021.1956.
A 52-year-old man was re-admitted two weeks after recovering from severe COVD-19 following a 3-days history of cough and worsening shortness of breath. The chest radiograph showed a large right-sided pneumothorax. The first attempt at drainage, performed through a large bored tube, failed. Due to the large dimension of the pneumothorax, and the lung condition (extensive consolidation and diffuse bullous dystrophies), the only thoracic surgical approach prospected was a pneumonectomy. Willing to preserve the lung, the pulmonology team attempted a multi-phase medical-oriented strategy based on medical thoracoscopy. Therefore, the patient underwent 5 chest tube insertions, 2 talc pleurodesis, and an intrapleural blood patch. Air leakage resolution was progressively achieved, and the patient became asymptomatic.
一位 52 岁男性在因严重 COVID-19 住院并康复出院两周后，因咳嗽和呼吸困难加重再次入院。胸部 X 线片显示右侧气胸较大。首次尝试通过大口径引导管引流失败。由于气胸的大尺寸以及肺部状况（广泛实变和弥漫性大疱性肺发育不良），唯一可行的胸部手术方法是肺切除术。为了保留肺部，呼吸科团队基于胸腔镜尝试了多阶段以医学为导向的策略。因此，患者接受了 5 次胸腔管插入、2 次滑石粉胸膜固定术和 1 次胸腔内血液贴剂。逐步实现了漏气的解决，患者无症状。
