■肺切除术后漏气延长是常见的并发症,纤维蛋白胶用作密封剂以减少这种情况。纤维蛋白胶引起的不良事件通常很少见。在这里,我们描述了一例罕见的纤维蛋白胶诱导的嗜酸性胸腔积液(EPE)。
方法:一名77岁男子因右下叶肺癌接受部分肺切除术,随后用纤维蛋白胶覆盖肺钉残端。给予抗菌药物治疗术后肺炎。然而,观察到炎症细胞数量的重新升高,计算机断层扫描显示右侧胸腔积液增加。虽然胸腔镜检查是基于脓胸的可能性,未观察到脓胸。胸腔积液中嗜酸性粒细胞计数为11%;因此,病人被诊断患有EPE,胸腔引流后解决了,没有皮质类固醇给药。纤维蛋白胶被确定为病原体,使用药物诱导的淋巴细胞刺激试验。
■EPE定义为胸腔积液中嗜酸性粒细胞计数≥10%。如果手术侧胸腔积液,发烧或炎症细胞数量升高,在肺切除术后的术后早期观察到,脓胸应该被认为是最重要的。在这种情况下,抗菌药物的管理是无效的,患者最终被诊断为EPE。
结论:EPE应被视为肺切除术后一种罕见的纤维蛋白胶引起的不良事件。建议检查白细胞分数,如果收集胸腔积液为术后胸腔积液。
UNASSIGNED: Prolonged air leakage after pulmonary resection is a common complication, and fibrin glue is used as a sealant to reduce this. Fibrin glue-induced adverse events are generally rare. Herein, we describe a rare case of fibrin glue-induced eosinophilic pleural effusion (EPE).
METHODS: A 77-year-old man underwent partial pulmonary resection for right lower lobe lung cancer, and the pulmonary staple stump was subsequently covered with fibrin glue. Antibacterial drugs were administered for the treatment of postoperative pneumonia. However, re-elevation of the inflammatory cell number was observed, and computed tomography revealed an increase in right pleural effusion. Although thoracoscopy was performed based on a possibility of empyema, no empyema was observed. The eosinophil count in the pleural effusion was 11%; thus, the patient was diagnosed with EPE, which was resolved after thoracic drainage, without corticosteroid administration. Fibrin glue was identified as the causative agent, using a drug-induced lymphocyte stimulation test.
UNASSIGNED: EPE is defined as an eosinophil count of ≥10% in the pleural effusion. If pleural effusion on the surgical side, with fever or an elevated inflammatory cell number, is observed in the early postoperative period after pulmonary resection, empyema should be considered foremost. In this case, the administration of antibacterial drugs was ineffective, and the patient was eventually diagnosed with EPE.
CONCLUSIONS: EPE should be considered as a rare fibrin glue-induced adverse event after pulmonary resection. It is recommended that the leukocyte fraction be examined, if pleural effusion is collected for postoperative pleural effusion.