钝性伤致支气管断裂的外科诊治(附33例报告)

Diagnosis and Treatment of Bronchus Fracture due to Blunt Injury (33 Cases Report)

目的探讨钝性伤致支气管断裂的外科诊疗体会. 方法 33例支气管断裂病人确诊后均行手术治疗,其中全肺切除5例,支气管袖状成形术4例,支气管重建术24例. 结果本组治愈29例,死亡4例;随访24例,时间6月～2年,除2例吻合口周围出现肉芽组织予以剪除外,余22例吻合口通畅良好. 结论支气管断裂多有特定的临床表现,CT及纤维支气管镜检查在诊断中起重要作用.一经确诊即应手术治疗,首选支气管重建术.

Objective To investigate the diagnosis and t re atment of bronchus fracture due to blunt injury. Methods 33 cases of bronchus fracture underwent operation after estabishment of diagno sis, including total pneumonectomy in 5 cases, bronchalplasty in 4 cases, and br onchus reconstruction in 24 cases. Results 29 cases cured and 4 cases died. Within 6 months to 2 years follow-u p in 24 cases, 22 cases had unobstructed anastomosis besides 2 cases had intraan astomotic granulation which were resected by bronchoscopy. Conclusio n Most of bronchus fracture have specific clinical manifestation, co mputer tomography and bronchoscopy play a key role in establishing the diagnosis . Bronchus reconstruction is optimal for surgical treatment.