Department of Pneumology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Department of Pneumology, Centre Hospitalier Universitaire de Liège, Liège, Belgium.
Int J Chron Obstruct Pulmon Dis. 2022 Aug 2;17:1735-1742. doi: 10.2147/COPD.S363490. eCollection 2022.
Endoscopic lung volume reduction using unidirectional endobronchial valves is a new technique in the treatment of patients with severe emphysema. However, the movements of the thoracic structures after endobronchial valves insertion are still unpredictable We report the unusual outcome of six patients after valves insertion in the left upper lobe. They all developed a complete atelectasis of the target lobe, a pneumothorax and sequential genuine bullae in the treated left lung of unknown etiology. The chest CT scan prior to the valves insertion was unremarkable. Three patients developed an air-liquid level in the bullae the day before a bacterial infection of their left lower lobe. The three other patients had an uneventful spontaneous resolution of their bullae at long-term follow-up. Therefore, a conservative attitude should be followed in this particular setting.
使用单向支气管内瓣膜进行内镜肺减容术是治疗严重肺气肿患者的一种新方法。然而，支气管内瓣膜插入后胸结构的运动仍然是不可预测的。我们报告了 6 例左上叶支气管内瓣膜插入后不寻常的结果。他们的目标肺叶均完全发生肺不张，气胸和序贯性真性大疱，病因不明。在插入瓣膜之前的胸部 CT 扫描未见异常。3 例患者在左下叶细菌感染前一天出现大疱内气液平面。另外 3 例患者在长期随访中自发性地解决了他们的大疱，没有出现任何并发症。因此，在这种特殊情况下应采取保守态度。
