中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2021, Vol. 43 ›› Issue (2): 211-215.doi: 10.3881/j.issn.1000-503X.12784

• 论著 • 上一篇    下一篇

自体血“补片”胸膜固定术治疗肺切除术后持续性漏气的疗效分析

李宝重,张旭刚,李维青,李志田,郭惠琴,姜福胜()   

  1. 首都医科大学附属北京世纪坛医院胸部外科,北京 100038
  • 收稿日期:2020-03-27 出版日期:2021-04-28 发布日期:2021-05-10
  • 通讯作者: 姜福胜 E-mail:baozhonglee@163.com

Pleurodesis with an Autologous Blood Patch in the Treatment of Persistent Air Leak after Lung Resection

LI Baozhong,ZHANG Xugang,LI Weiqing,LI Zhitian,GUO Huiqin,JIANG Fusheng()   

  1. Department of Thoracic Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China
  • Received:2020-03-27 Online:2021-04-28 Published:2021-05-10
  • Contact: JIANG Fusheng E-mail:baozhonglee@163.com

摘要:

目的 观察自体血“补片”胸膜固定术治疗肺切除术后持续肺漏气的安全性及疗效,探讨该方法在临床治疗中的应用价值。方法 2014年10月至2019年10月北京世纪坛医院胸外科收治97例肺部持续漏气患者,其中53例采用自体血胸膜腔注入治疗,44例采用常规治疗方法,回顾性分析两组治疗方法的疗效、不良反应和并发症等情况。结果 自体血治疗组81.1%的患者经第1次治疗后48 h内肺漏气停止,其余18.9%的患者经第2次自体血输注后治愈,平均带管时间8.4 d,总体成功率100%,术后平均住院日10.0 d。而常规治疗组中漏气持续时间较长,平均带管时间13.5 d,术后平均住院日15.3 d。两组患者术后拔管时间(P=0.00)和术后住院时间(P=0.00)差异均有统计学意义。除少数患者出现皮下气肿、低热外,未观察到严重并发症的发生。结论 自体血“补片”胸膜固定术治疗持续肺漏气疗效确切,不良反应发生率低,可作为治疗持续肺漏气的首选方法。

关键词: 自体血“补片”, 胸膜固定术, 持续性漏气, 肺切除术

Abstract:

Objective To evaluate the efficacy and risks of autologous blood patch pleurodesis in patients with persistent air leak(PAL)after lung resection. Methods A total of 97 patients with PAL after lung resection in Beijing Shijitan Hospital from October 2014 to October 2019 were retrospectively reviewed,including 53 treated by autologous blood patch pleurodesis and 44 by the conventional way.The therapeutic effect,adverse reactions and complications were analyzed. Results All the patients with PAL were cured with autologous blood patch pleurodesis.Most air leaks(81.1%)ceased within 48 hours after treatment,and the left 18.9% patients got cured after a repeat.The mean tube retention time and the mean in-hospital stay were 8.4 days and 10.0 days in the autologous blood patch pleurodesis group and 13.5 days and 15.3 days in the conventional treatment group.A prolonged drainage time(P=0.00)and in-hospital stay(P=0.00)were observed in the conventional treatment group.No severe complications were observed except two patients developed slight fever and cutaneous emphysema. Conclusion In our experience,the autologous blood patch pleurodesis is an effective way with low risk of adverse reactions in the treatment of PAL.

Key words: autologous blood patch, pleurodesis, persistent air leak, lung resection

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