经皮穿刺肺大疱内固定减容术治疗巨大肺大疱

目的观察肺大疱内固定减容术治疗肺大疱的疗效。方法采取前瞻性自身对照的方法，对22例（个）巨大肺大疱实施肺大疱内固定减容术。结果22例肺大疱中最小者约10 cm×7 cm×5 cm（前后径×内外径×上下径，下同），最大者约15 cm×8 cm×30 cm（累及一侧整半个胸腔）。19例在术后7天内肺大疱闭合，1例在术后15天闭合，2例在术后10天和14天缩小并稳定，所有病例均获呼吸困难减轻或消失，肺功能改善。随访4-42个月，失访2例，余无1例复发和加重。结论CT引导经皮肺大疱内固定减容术只需局麻，创伤小、费用低、并发症少、疗效确切，是巨大肺大疱的安全有效的治疗方法。

Lung volume reduction surgery by intra-bullous adhesion pexy by percutaneous lung centesis,an alternative in the management of giant bullae

Objective To explore a safe and effective strategy in the management of giant bullae. Methods Lung volume reduction surgery by intra-bullous adhesion pexy with biomedical fibrin sealant and closed drainage by percutaneous lung centesis were carried out in 22 cases of giant bullae. The clinical data was analyzed by prospective random self-controlled study. Results The giant bullae size from 10 cm × 7 cm × 5 cm to 15 cm × 8 cm × 30 cm, 19 cases were cured with disappearred cavities in 7 days after the procedure, 1 case in 15 days, and 2 cases with reduced cavities in 10 days and 14 days respectively. Dyspnoea was alleviated or disappeared, and pulmonary function was improved significantly. No recurrence or aggravation was found in 20 cases followed up for 4 to 42 months and 2 cases lost. Conclusion A safe and effective strategy for giant bullae is Lung volume reduction surgery by intra-bullous adhesion pexy guided by computed tomography in local anaesthesia with mild wound, less complications and cheap fee-for-service.