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外伤性支气管断裂的诊治体会 被引量:13

Diagnosis and treatment of traumatic bronchial rupture
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摘要 目的 探讨外伤性支气管断裂的早期诊断与外科治疗。方法 对 1997年 1月至2 0 0 3年 1月诊治的 7例外伤性支气管断裂患者的临床表现及外科治疗情况进行回顾性分析。结果  7例患者均为胸部钝性伤 ,支气管断裂症状典型的 5例患者得到了早期诊断 ,无典型临床表现的2例患者诊断延误。全组均行支气管端端吻合术。 6例患者痊愈出院 ,1例术前呼吸心跳骤停 ,术后第 7天因脑未复苏死亡。结论 伤后出现典型临床表现 ,尤其是充分闭式引流后不能控制的气胸 ,支气管断裂的诊断可基本确定。一部分支气管断裂患者早期无明显临床表现 ,胸部CT和纤维支气管镜检查可确诊。诊断一经确立 ,应尽快行支气管吻合术。 Objective To investigate the diagnosis and treatment of traumatic bronchial rupture.Methods Clinical data of 7 patients with traumatic bronchial rupture treated in our hospital from January 1997 to January 2003 were analyzed retrospectively.Results All patients were caused by blunt thoracic trauma.Among them,5 patients presented immediately with dyspnea,subcutaneous emphysema,pneumomediastinum,pneumothorax,“drop lung”sign and were diagnosed early.Two of these patients were asymptomatic and had no early diagnosis.All patients were operated by means of end to end bronchial anastomosis.Six patients recovered from the injuries after surgical treatment.One died of brain death 7 days after cardiopulmonary resuscitation and surgery.Conclusion The diagnosis of bronchial rupture should be considered at once when patients have typical symptoms and pneumothorax refractory to thoracostomy tube drainage.However,for some patients whose initially symptoms were mild or absent, it was difficult to diagnose.Bronchoscopy and spiral CT scan were the most useful methods for diagnosis and localization of bronchial injury for these patients.When the diagnosis was established, prompt surgical therapy should be carried out as soon as possible.
出处 《临床外科杂志》 2005年第3期175-177,共3页 Journal of Clinical Surgery
关键词 支气管断裂 支气管重建 创伤 诊断 治疗 bronchial rupture bronchial reconstruction traumatic diagnosis treatment
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  • 1Chen DY,Han LB,Hu YX,et al.Diagnosis and treatment of bronchial rupture from blunt thoracic trauma[J].Chin Med J (Engl),2001,114(5)∶540-541.

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