Morita Chie, Kitamura Atsushi, Okafuji Kohei, Ro Shosei, Imai Ryosuke, Shirasaki Kasumi, Watanabe Yu, Nishimura Naoki
Department of Pulmonary Medicine Thoracic Center, St. Luke's International Hospital Tokyo Japan.
Emergency and Critical Care Medicine St. Luke's International Hospital Tokyo Japan.
Respirol Case Rep. 2022 Mar 13;10(4):e0923. doi: 10.1002/rcr2.923. eCollection 2022 Apr.
Coronavirus disease 2019 (COVID-19) causes pneumothorax or mediastinal emphysema in approximately 1% of patients. According to the British Thoracic Society guidelines, the next treatment option for patients with persistent pneumothorax despite chest drainage is pleurodesis or surgery. In fact, there are reports of autologous blood pleurodesis or surgery for the treatment of pneumothorax caused by COVID-19. However, elderly patients or patients in poor general condition may not be able to tolerate surgical invasion. In this report, we present two patients who did not respond to chest drainage or pleurodesis and who were not suitable for surgery because of their poor general condition. These patients were successfully treated with an endobronchial Watanabe spigot and -butyl-2-cyanoacrylate. This method may be an option for the treatment of refractory pneumothorax in COVID-19.
2019冠状病毒病（COVID-19）在约1%的患者中会导致气胸或纵隔气肿。根据英国胸科学会指南，对于尽管进行了胸腔引流但气胸仍持续存在的患者，下一个治疗选择是胸膜固定术或手术。事实上，有关于采用自体血胸膜固定术或手术治疗COVID-19所致气胸的报道。然而，老年患者或全身状况较差的患者可能无法耐受手术侵袭。在本报告中，我们介绍了两名对胸腔引流或胸膜固定术无反应且因全身状况较差而不适合手术的患者。这些患者通过支气管内渡边套管和氰基丙烯酸正丁酯成功得到治疗。该方法可能是治疗COVID-19难治性气胸的一种选择。
