摘要
目的探讨肺大疱性肺脓肿相关靶支气管定位方法,及其经胸壁和气道双路介入治疗的效果和安全性。方法肺大疱性肺脓肿29例,平均直径14 cm,其中慢性阻塞性肺疾病(COPD)25例。肺脓肿相关靶支气管定位方法:术前肺CT,常规纤支镜检查,反向和正向有色盐水定位。CT引导下,经胸壁肺脓肿内置入中心静脉导管,行脓腔抽吸、灌洗、注药和持续负压吸引。纤支镜直视下,应用纤维蛋白黏合剂封堵肺脓肿靶支气管。结果29例患者中,经肺CT肺脓肿靶支气管定位17例,常规纤支镜定位23例,反向和正向有色盐水定位分别为26和24例。治愈25例、好转3例,有效率96.6%。胸痛3例,气胸2例,脓胸、脓气胸和皮下气肿各1例,胸壁引流管脱落和移位各1例。结论经胸壁、气道双路介入治疗肺大疱性肺脓肿是一种简单、安全和有效的方法。
Objective To evaluate the efficacy and safety of locating the target bronchus and treating through the chest wall and airway intervention in 29 cases with lung abscess secondary to pulmonary bulla. Methods In 29 cases the lung abscess secondary to pulmonary bulla had a mean diameter of 14 cm, of which 25 with COPD. Implementing 4 different ways to locate the target bronchus of lung abscess： Preoperative pulmonary CT, conventional fiber bronchoscopy, and locating the target bronchus by infecting colored saline separately forward and backward. Under guiding of CT, the central venous catheter was inserted via chest wall into lung abscess, which had pus suction, lavage, medicine injection and continuous negative pressure suction and then under direct vision of bronchoscopy, all of the target bronchi of pulmonary absess were occluded with fibrin glue. Results All of the 29 cases, the target bronchi of lung abscess were localized by lung CT in 17, by conventional bronchoscopy in 23, and by infecting colored saline forward in 26 and backward in 24 respectively. Cured in 25 and improved in 3, the total effective rate was 96.6%. The adverse effects： chest pain in 3, pneumothorax in 2, pyothorax, pyopneumothorax, subcutaneous emphysema, the drainage catheter falling off and dislocating separately in 1. Conclusion It was simple, safe and effective to treat lung abscess secondary to lung bulla through the chest wall and airway intervention.
出处
《中国内镜杂志》
北大核心
2016年第6期97-100,共4页
China Journal of Endoscopy
关键词
肺
大疱
脓肿
亚甲蓝
介入
lung
bulla
abscess
methylene blue
intervention
