手術困難な気胸に対する低用量50％ブドウ糖液を用いた胸膜癒着療法

Small Volume of 50％ Glucose Solution Pleurodesis for Management of Inoperable Patients with Pneumothorax

手術の選択がむずかしいような気胸例では胸膜癒着療法が考慮される．さまざまな癒着療法の中で比較的安全性が高く，安価な高張ブドウ糖液を用いた癒着療法が近年報告されているが，その安全性と有効性に関してはいまだ不明確である．

This interim report presents the results of pleurodesis with 50 ml of 50％ glucose solution for patients with inoperable pneumothorax. Twenty patients were enrolled, and treatment was performed for 22 sites in total. The degree of lung collapse was mild in 2 cases, moderate in 12 cases, and severe in 8 cases. The mean number of treatments was 1.4 times （range 1～3）. Mild chest pain after injection occurred in one case, and additional chest tube insertion was required for pleural effusion in one case. Other side effects, such as fever or dehydration, were not observed. On day one the mean blood glucose level was 145.0 mg/dl （range 103～259）, and the mean pleural effusion volume was 284.6 ml （range 5～910）. The air leakage was successfully controlled in 20 of the 22 sites （91％）. Pleurodesis in this manner was thought to be useful intervention for inoperable patients with pneumothorax.