■胸膜造影术(PG)先前已被描述,但尚未普及。PG可以确定肺部的确切漏气点,这对于治疗气胸和胸膜瘘很重要。我们认为应该重新评估PG的有用性,在这里我们描述的方法,漏气检测率,和常见的并发症。
从2015年3月至2018年10月在我们机构治疗的1210例胸膜瘘病例中,选择275例复发性原发性气胸或继发性自发性气胸患者进行本研究。对127例呼气期间持续漏气的患者进行了PG检查。此外,包括35例持续7天或更长时间的漏气术后并发症。
■在119名患者(73%)中检测到空气泄漏点,在65例肺尖,在13例基底段,中叶或舌节9例。肺门病变8例,S6病变12例,8例除根尖以外的上叶病变,上纵隔病变4例。30天内出现并发症10例(6.2%),有8例2级发热,1例3级感染病例,1例腹胀1例。
■PG后≥3级不良事件的发生率为0.6%,这被认为是可以接受的。我们的发现表明,PG是一种安全的检查方法,可在胸膜瘘手术前识别漏气。
UNASSIGNED: Pleurography (PG) has been described previously but has not gained popularity. PG can determine the exact air leak points in the lung, which is important for treating pneumothorax and pleural fistulas. We believe that the usefulness of PG should be reassessed, and here we describe the method, air leak detection rate, and common complications.
UNASSIGNED: From the 1210 cases of pleural fistulas that were treated at our institution between March 2015 and October 2018, 275 patients with recurrent primary pneumothorax or secondary spontaneous pneumothorax were selected for this study. PG was performed in 127 patients with persistent air leakage during exhalation. In addition, 35 patients with postoperative complications of air leakage persisting for 7 days or longer were included.
UNASSIGNED: Air leak points were detected in 119 patients (73%), in the apex of the lung in 65 cases, in the basal segment in 13 cases, and in the middle lobe or lingular segment in 9 cases. There were 8 cases of hilar lesions, 12 cases of S6 lesions, 8 cases of upper lobe lesions other than apex, and 4 cases of upper mediastinal lesions. Complications within 30 days were observed in 10 cases (6.2%), with 8 grade 2 cases involving fever, 1 grade 3 case involving infection, and one grade 1 case with abdominal distension.
UNASSIGNED: The incidence of grade ≥3 adverse events after PG was 0.6%, which is considered acceptable. Our findings suggest that PG is a safe examination method to identify air leaks before surgery for pleural fistulas.