Background Air leak is the most common complication after lung resection and leads to increased length of hospital (LOH) stay or patient discharge with a chest tube. Management by autologous blood patch pleurodesis (ABPP) is controversial because few studies exist, and the technique has yet to be standardized.

Methods We retrospectively reviewed patients undergoing ABPP for prolonged air leak (PAL) following lobectomy in three centers, between January 2014 and December 2019. They were divided into two groups: Group A, 120 mL of blood infused; Group B, 60 mL. Propensity score-matched (PSM) analysis was performed, and 23 patients were included in each group. Numbers and success rates of blood patch, time to cessation of air leak, time to chest tube removal, reoperation, LOH, and complications were examined. Univariate and multivariate analysis of variables associated with an increased risk of air leak was performed.

Results After the PSM, 120 mL of blood is statistically significant in reducing the number of days before chest tube removal after ABPP (2.78 vs. 4.35), LOH after ABPP (3.78 vs. 10.00), and LOH (8.78 vs. 15.17). Complications (0 vs. 4) and hours until air leak cessation (6.83 vs. 3.91, range 1–13) after ABPP were also statistically different (p < 0.05). Air leaks that persisted for up to 13 hours required another ABPP. No patient had re-operation or long-term complications related to pleurodesis.

Conclusion In our experience, 120 mL is the optimal amount of blood and the procedure can be repeated every 24 hours with the chest tube clamped.

背景 漏气是肺切除术后最常见的并发症，会导致住院时间 (LOH) 增加或患者出院时需要放置胸管。自体血补片胸膜固定术 (ABPP) 的管理存在争议，因为存在的研究很少，而且该技术尚未标准化。

方法 我们回顾性分析了 2014 年 1 月至 2019 年 12 月期间在三个中心接受肺叶切除术后长期漏气（PAL）的 ABPP 患者。他们分为两组：A 组，输血 120 mL；B 组，60 毫升。进行了倾向得分匹配（PSM）分析，每组包括 23 名患者。检查血补片的数量和成功率、停止漏气的时间、拔除胸管的时间、再次手术、LOH 和并发症。对与漏气风险增加相关的变量进行了单变量和多变量分析。

结果 PSM 后，120 mL 血液在减少 ABPP 后胸管拔除前天数（2.78 对 4.35）、ABPP 后 LOH（3.78 对 10.00）和 LOH（8.78 对 15.17）方面具有统计学意义。ABPP 后并发症（0 对 4）和漏气停止前的小时数（6.83 对 3.91，范围 1-13）也有统计学差异（p  < 0.05）。持续长达 13 小时的漏气需要另一个 ABPP。没有患者出现与胸膜固定术相关的再次手术或长期并发症。

结论 根据我们的经验，120 mL 是最佳血液量，并且可以在夹住胸管的情况下每 24 小时重复一次该过程。