Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, California, USA,
Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of California Irvine, Irvine, California, USA.
Respiration. 2024;103(5):289-294. doi: 10.1159/000537992. Epub 2024 Feb 28.
Pulmonary infections, such as tuberculosis, can result in numerous pleural complications including empyemas, pneumothoraces with broncho-pleural fistulas, and persistent air leak (PAL). While definitive surgical interventions are often initially considered, management of these complications can be particularly challenging if a patient has an active infection and is not a surgical candidate.
Autologous blood patch pleurodesis and endobronchial valve placement have both been described in remedying PALs effectively and safely. PALs due to broncho-pleural fistulas in active pulmonary disease are rare, and we present two such cases that were managed with autologous blood patch pleurodesis and endobronchial valves.
The two cases presented illustrate the complexities of PAL management and discuss the treatment options that can be applied to individual patients.
肺部感染，如肺结核，可能导致多种胸膜并发症，包括脓胸、伴有支气管胸膜瘘的气胸和持续性肺漏气（PAL）。虽然通常最初会考虑进行明确的手术干预，但如果患者存在活动性感染且不适合手术，这些并发症的治疗可能会特别具有挑战性。
自体血胸膜固定术和支气管内瓣膜放置术均已被描述为有效且安全地治疗 PAL。活动性肺部疾病引起的支气管胸膜瘘所致的 PAL 较为罕见，我们报告了两例此类病例，均采用自体血胸膜固定术和支气管内瓣膜治疗。
提出的两个病例说明了 PAL 管理的复杂性，并讨论了可应用于个体患者的治疗选择。
