使用 Penrose 引流导管进行胸腔引流引起的深部肺损伤的截断术：病例报告,Surgical Case Reports

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使用 Penrose 引流导管进行胸腔引流引起的深部肺损伤的截断术：病例报告
Surgical Case Reports ( IF 0.7 ) Pub Date : 2021-06-01 , DOI: 10.1186/s40792-021-01215-6
Hironori Oyamatsu ₁ , Hideki Tsubouchi ₂ , Kunio Narita ₃

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肺牵引切开术有效治疗深部肺穿通伤；然而，它需要将镊子或订书机准确插入伤口道。本报告描述了一例使用 Penrose 引流导管进行胸腔引流引起的深部肺损伤的牵引切开术。一名 75 岁的男子多处肋骨骨折和血胸。入院后因右侧胸腔积液增多，患者呼吸状况恶化，行胸管引流。然而，当胸管刺入右上叶时，进行了肺管道切开术以治疗损伤。切开胸管尖端上方的脏层胸膜导致管子完全穿透肺。将彭罗斯引流管固定在胸管上，然后将其取出。Penrose 引流管完全穿透肺并连接到吻合器的砧侧，以将其顺利导入伤口道。在缝合使伤口道打开后，对受损血管和细支气管进行选择性缝合结扎。尽管使用 Penrose 引流导管进行牵引切开术的适应证有限，但我们相信该技术可用于具有杆状或管状异物残留物的深刺伤或穿透性肺损伤的患者。

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Tractotomy using the Penrose drain guide for deep lung injury caused by chest drainage: a case report

Pulmonary tractotomy effectively treats deep pulmonary penetrating injuries; however, it requires the accurate insertion of forceps or a stapler into the wound tract. This report describes a case of tractotomy using the Penrose drain guide for a deep lung injury caused by chest drainage. A 75-year-old man suffered multiple rib fractures and hemothorax. After admission, chest tube drainage was performed because the patient’s respiratory condition deteriorated due to increased right pleural effusion. However, as the chest tube was stabbing into the right upper lobe, a pulmonary tractotomy was performed to treat the injury. Cutting the visceral pleura just over the tip of the chest tube caused the tube to completely penetrate the lung. A Penrose drain tube was fixed to the chest tube, which was then removed. The Penrose drain tube completely penetrated the lung and was coupled to the anvil side of the stapler to guide it smoothly into the wound tract. After stapling left the wound tract open, selective suture ligation of the damaged vessel and bronchioles was performed. Although the indications for tractotomy using the Penrose drain guide are limited, we believe that this technique can be useful in patients with deep stabbing or penetrating lung injuries with rod- or tube-shaped foreign body remnants.

更新日期：2021-06-01

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