中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (8): 1491-1494.doi: 10.3969/j.issn.1673-8225.2010.08.039

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

经内镜注射生物蛋白胶联合微波治疗支气管胸膜瘘8例

刘建明1，2，刘新民3，孙圣华1，张阳德2，刘备战1   

  1. 1中南大学湘雅三医院呼吸科，湖南省长沙市  410013；中南大学，2生物医学工程研究院，3公共卫生学院，湖南省长沙市  410078
  • 出版日期:2010-02-19 发布日期:2010-02-19
  • 通讯作者: 刘新民，硕士，讲师，中南大学公共卫生学院，湖南省长沙市 410078 liuxinmin42@xysm.net
  • 作者简介:刘建明☆，男，1969年生，湖南省长沙市人，苗族，2008年中南大学毕业，博士，主治医师，主要从事内镜在呼吸疾病诊断及治疗中的应用。 Liujianming101@sina.com

Treatment of bronchopleural fistula using injection of fibrin sealant combined with microwave under endoscope in 8 cases

Liu Jian-ming 1,2, Liu Xin-min3, Sun Sheng-hua1, Zhang Yang-de2, Liu Bei-zhan1   

  1. 1 Department of Respiratory Diseases, Third Xiangya Hospital of Central South University, Changsha  410078, Hunan Province, China; 2 Institute of Biomedical Engineering, 3 Public Health School, Central South University, Changsha  410078, Hunan Province, China
  • Online:2010-02-19 Published:2010-02-19
  • Contact: Liu Xin-min, Master, Lecturer, Public Health School of Central South University, Changsha 410078, Hunan Province, China liuxinmin42@xysm.net
  • About author:Liu Jian-ming☆, Doctor, Attending physician, Department of Respiratory Diseases, Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China; Institute of Biomedical Engineering, Central South University, Changsha 410078, Hunan Province, China Liujianming101@sina.com

PDF

378

被引次数

6

摘要：

背景：支气管胸膜瘘传统的治疗主要包括保守治疗和手术治疗两大类。随着内镜介入治疗的发展，一种安全、有效的新方法正引起关注。
目的：探讨在支气管镜引导下注射生物蛋白胶联合明胶海绵填塞治疗肺切除术后支气管胸膜瘘的疗效。
方法：8例支气管胸膜瘘患者接受经支气管镜微波治疗及明胶海绵填塞后注射生物蛋白胶封堵瘘口的治疗。男6例，女2例，平均年龄为53.8岁(39~73岁)。病例7、病例8为左全肺切除，病例1、病例2为左上肺叶切除，病例3为左下肺叶切除，病例4为右下肺叶切除，病例5、病例6为右上肺叶切除。病例4和病例8为术后化疗后出现支气管胸膜瘘的表现。
结果与结论：病例8不成功，因瘘口大于5 mm，封堵6次，瘘口未闭，患者放弃治疗而失败，以永久胸腔引流出院。其余7例获得痊愈。注射次数以及住院时间与瘘口大小有一定的联系，瘘口小于3 mm的4例患者均一次封堵成功。而瘘口介于3~5 mm的3例患者注射次数分别为3次和5次。在经支气管镜生物蛋白胶封堵治疗的病例中未发生严重的并发症以及不良反应。说明支气管镜引导注射生物蛋白胶联合明胶海绵和微波治疗支气管胸膜瘘是一种安全、有效的方法。

关键词: 生物蛋白胶, 明胶海绵, 支气管胸膜瘘, 支气管镜, 微波, 生物材料

Abstract:

BACKGROUND: Traditional treatment includes conservative therapy and surgical treatment on bronchial pleural fistula. With the development of endoscopic therapy, a new safe and effective method is concerned.
OBJECTIVE: To summarize the therapeutic effect of treating bronchopleural fistula using bronchoscopy-guided injection of fibrin sealant combined with gelatin sponge filled and microwave following after lung resection.
METHODS: Totally 8 cases of bronchial fistula patients were received injection of fibrin sealant after microwave and gelatin sponge filled by bronchoscopy, including 6 males and 2 females, mean aged 53.8 years (39-73 year-old). Cases 1 and 2 received left upper pulmonary lobectomy, cases 3 received left lower pulmonary lobectomy, case 4 received right lower pulmonary lobectomy, cases 5 and 6 received right upper pulmonary lobectomy, and the cases 7 and 8 received pneumonectomy. bronchopleural fistula occurred after postoperative Chemotherapy in cases 4 and 8.
RESULTS AND CONCLUSION: The case 8 was failed to treatment due to the large orificium fistulae (> 5 mm) and disappointed results after 6 times plugging. The other 7 patients were cured successfully. The injection time was correlated to the size of orificium fistulae, and the plugging was successful for 4 patients with less than 3 mm orificium fistulae. However, a third or fifth plugging was performed for 3 cases with 3-5 mm orificium fistulae. No surgery-related complications occurred in all patients. Bronchoscopy guided injection of fibrin sealant combined with gelatin sponge and microwave is a safe and effective method for bronchial fistula.

中图分类号: