报告两例老年男性复发性气胸患者，在留置24-Fr胸腔引流管后出现引流管误入肺组织这一罕见并发症的诊治过程。两例患者均表现为置管后引流不畅、皮下气肿，经胸部计算机断层扫描（CT）明确诊断。在保守治疗中，我们采用另选部位重新置管的策略，促进肺复张，最终两例患者均顺利出院，随访肺复张良好。本病例报告提示，对于老年、复发性气胸、存在胸腔粘连高危因素的需要留置胸腔引流管的患者，通过胸部CT评估选择合适的置管位置，操作中手指探查胸腔，及避免使用带引导钢芯的引流管对于预防此类并发症至关重要；一旦发生引流管误入肺组织，通过暂缓拔除原有闭式引流管，以起到部分压迫作用；同时留置新的引流管可以作为安全有效的首选治疗策略。

This paper reports the diagnosis and management of two elderly male patients with recurrent pneumothorax who developed the rare complication of chest tube misplacement into lung tissue after insertion of a 24-Fr chest tube. Both patients presented with poor drainage and subcutaneous emphysema following tube placement, and the diagnosis was confirmed by chest computed tomography (CT). As conservative management, we adopted a strategy of reinserting a new chest tube at an alternative site to promote lung re-expansion. Both patients were discharged uneventfully, with good lung re-expansion observed during follow-up. These cases suggest that for elderly patients with recurrent pneumothorax and those at high risk of pleural adhesions who require chest tube drainage, preoperative chest CT evaluation, selection of an appropriate insertion site, digital exploration of the pleural cavity during the procedure, and avoidance of chest tubes with an introducer stylet are crucial for preventing this complication. When chest tube misplacement into the lung tissue occurs, leaving the original tube in place to provide a partial tamponade effect while simultaneously inserting a new chest tube may serve as a safe and effective first-line conservative strategy.