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经支气管镜肺减容术治疗 COVID-19 合并大疱性肺气肿患者持续漏气

Successful use of endobronchial valve for persistent air leak in a patient with COVID-19 and bullous emphysema.

机构信息

Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, Missouri, USA

Department of Nursing, Goldfarb School of Nursing at Barnes-Jewish College, St Louis, Missouri, USA.

出版信息

BMJ Case Rep. 2021 Nov 19;14(11):e246671. doi: 10.1136/bcr-2021-246671.

DOI:10.1136/bcr-2021-246671
PMID:34799393
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8606771/
Abstract

Patients with SARS-CoV-2 pneumonia can suffer from pneumothorax and persistent air leak (PAL). The pneumothorax occurs with or without pre-existing lung disease. PAL refers to air leak lasting more than 5-7 days and arises due to bronchopleural or alveolopleural fistula. The management of PAL can be challenging as a standard management guideline is lacking. Here we present the case of a 42-year-old smoker with COVID-19 who presented to the hospital with fever, cough, acute left-sided chest pain and shortness of breath. He suffered from a large left-sided pneumothorax requiring immediate chest tube drainage. Unfortunately, the air leak persisted for 13 days before one-way endobronchial valve (EBV) was used with complete resolution of the air leak. We also review the literature regarding other cases of EBV utilisation for PAL in patients with COVID-19.

摘要

SARS-CoV-2 肺炎患者可发生气胸和持续性肺漏气（PAL）。气胸可伴或不伴先前存在的肺部疾病。PAL 是指漏气持续 5-7 天以上，由于支气管胸膜或肺泡胸膜瘘引起。由于缺乏标准的管理指南，PAL 的管理具有挑战性。在这里，我们报告了一例 42 岁的吸烟者，患有 COVID-19，因发热、咳嗽、急性左侧胸痛和呼吸急促而到医院就诊。他患有大量左侧气胸，需要立即进行胸腔引流管引流。不幸的是，漏气持续了 13 天，然后使用单向支气管内瓣膜（EBV），完全解决了漏气问题。我们还回顾了关于 COVID-19 患者使用 EBV 治疗 PAL 的其他病例的文献。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/6f30cfdd6bac/bcr-2021-246671f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/c9569c69904e/bcr-2021-246671f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/1274d53bf1c5/bcr-2021-246671f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/3dafaa0e85fa/bcr-2021-246671f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/92813db7b277/bcr-2021-246671f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/36d470967e8a/bcr-2021-246671f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/6f30cfdd6bac/bcr-2021-246671f06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/c9569c69904e/bcr-2021-246671f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/1274d53bf1c5/bcr-2021-246671f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/3dafaa0e85fa/bcr-2021-246671f03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/92813db7b277/bcr-2021-246671f04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/36d470967e8a/bcr-2021-246671f05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14ce/8606771/6f30cfdd6bac/bcr-2021-246671f06.jpg

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