難治性気胸に対して自己血およびminocycline併用胸膜癒着術が奏効した1例

Successful Pleurodesis with Autologous Blood and Minocycline for Refractory Pneumothorax：Report of a Case

はじめに　気胸に対して，胸腔ドレナージなど治療介入後もエアリークが5日間以上持続する状態はpersistent air leak（PAL）と定義されている1）．PALは一般的に難治性気胸とも呼ばれ，それにいたる患者背景はさまざまであり確立された治療法はない．われわれは自己血とminocycline併用胸膜癒着術が奏効した難治性気胸の1例を報告する．

A 69-year-old man with lung cancer treated with cytotoxic drugs experienced refractory pneumothorax four times during two months in the right lung, leading to a persistent air leak （PAL） lasting more than five days. Pleurodesis was performed by various chemical drugs and autologous blood, but these procedures were not effective when treated alone. Due to his low-performance status and hypoalbuminemia, surgical intervention was not considered viable in terms of risk. Therefore, a combination of autologous blood and minocycline was successfully used to treat the refractory pneumothorax due to PAL. This combination therapy may serve as an alternative treatment for refractory pneumothorax and PAL.