Heimlich翼瓣引流管气胸引流术在肿瘤介入诊疗中的应用(附13例报告)

背景与目的:肿瘤患者在接受介入诊疗操作中(如穿刺活检、经皮穿刺肺癌射频消融治疗等),可能会并发气胸,且这类气胸多为单纯性气胸。传统的处理方法是采用胸腔引流管与水封瓶相连接的胸腔闭式引流术,此术创伤大,患者需要住院接受治疗。Heimlich翼瓣引流管(简称Heimlich管)用于胸腔引流在国外已有多年,但在国内罕有报道。本文通过总结13例肿瘤患者在介入诊疗中并发气胸后应用Heimlich管的经验,探讨这一微创技术的临床价值。方法:1999年3月～2003年2月对13例介入诊疗中并发气胸的肿瘤患者应用Heimlich管微创插管技术方法行气胸引流。患者中6例住院治疗,7例门诊观察。结果:所有气胸患者经Heimlich管引流2～3天后,气胸消失,塌陷的肺组织完全复张,无任何并发症发生。结论:Heimlich管连接置入胸腔的多侧孔猪尾形导管行气胸引流术具有操作简单快捷、安全可靠、疗效好、患者可在门诊接受观察等优点,尤其值得在胸腔肿瘤介入诊疗操作中并发单纯气胸的患者中推广应用。

Application of heimlich valve drainage to interventional procedure-induced pneumothorax in cancer patients: a report of thirteen cases

BACKGROUND & OBJECTIVE: Pneumothorax, usually pure pneumothorax, often occurs during interventional procedures (such as biopsy and percutaneous lung cancer radiofrequency ablation) applied in cancer patients. Traditional treatment of pneumothorax uses a thoracic drainage tube connected to an underwater seal device, and patient needs hospitalization for its huge trauma. Heimlich valve has been used in thoracic drainage for years abroad. This study was to investigate the clinical value of Heimlich valve drainage for interventional procedure-induced pneumothorax in cancer patients. METHODS: Heimlich valve connected to a chest catheter was used in treating interventional procedure-induced pneumothorax in 13 cancer patients from Mar. 1999 to Feb. 2003. RESULTS: Of the 13 patients, 6 accepted inpatient management, and 7 accepted outpatient management. The pneumothoraxes of all patients were disappeared 2-3 days after drainage, and the lungs were re-expanded well. No complications occurred. CONCLUSIONS: Heimlich valve pneumothorax drainage is micro-invasive, easy to perform, and safe, and can be managed in outpatient. It also can achieve good clinical results, and should be recommended when pneumothorax occurs during interventional procedure.