Nakamura S, Matsumura A, Hashimoto Y, Kawakami M
Department of Pneumology, Tokyo Metropolitan Hiroo General Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Nov;32(11):1115-9.
We successfully reduced a giant bulla using an intrabullar suction-adhesion method in a case of steroid-dependent intractable bronchial asthma. A 53-year-old woman was hospitalized with an asthma attack, and suffered pneumonia in the area surrounding a giant bulla after remission of two episodes of asthma. After the pneumonia, we found that the giant bulla had increased in volume. It was readily apparent that the bulla should be reduced. At that time a right side pneumothorax occurred by accident, which improved the chest drainage. Immediately after that, we inserted a chest drainage tube directly into the bulla and instilled fibrin glue through the tube into the bulla. Intrabullar suction and bronchial embolization via bronchofiberscopy has been used to patients with inoperable giant bullae of the lung. If intrabullar suction with fibrin glue alone can reduce giant bulla, it would offer another option to patients with inoperable giant bullae without the risk of a surgical procedure.
在一例类固醇依赖型难治性支气管哮喘患者中,我们成功地使用球囊内吸引-粘连法缩小了巨大肺大疱。一名53岁女性因哮喘发作入院,在两次哮喘发作缓解后,其巨大肺大疱周围区域发生了肺炎。肺炎发生后,我们发现巨大肺大疱的体积增大了。很明显,肺大疱应该缩小。当时意外发生了右侧气胸,这改善了胸腔引流。之后,我们立即将一根胸腔引流管直接插入肺大疱,并通过该管向肺大疱内注入纤维蛋白胶。球囊内吸引和经纤维支气管镜进行支气管栓塞已用于患有无法手术的巨大肺大疱的患者。如果仅用纤维蛋白胶进行球囊内吸引就能缩小巨大肺大疱,那么对于无法手术的巨大肺大疱患者来说,这将提供另一种选择,且无需承担手术风险。