开胸手术治疗复杂支气管异物

Thoracotomy for complicated foreign bodies in bronchi

目的探讨支气管异物需经开胸手术取出的原因。方法回顾性分析我院1993～2005年收治的采用开胸方法取出的支气管异物病历20例,其中男17例,女3例。结果20例患者中16位患者曾行硬性支气管镜检查未能取出异物;11位患者术前合并肺炎或肺不张等并发症;20例患者全部为非植物性异物;2例患者异物位于右主支气管、6例位于右上叶、2例位于左上叶以及10例位于左下叶;19例患者经开胸手术将异物取出,1例患者开胸手术时异物移位,后经硬性支气管镜将异物取出。结论开胸切开支气管是治疗支气管异物的方法之一,根据异物种类、位置、异物存留时间、并发症及相关检查等可判断是否需开胸手术。

OBJECTIVE To discuss the reasons of foreign bodies in bronchi which need to remove with thoracotomy. METHODS The clinical data of 20 cases underwent thoracotomy in order to remove the foreign bodies in bronchi from 1993 to 2005 were studied. There were 17 boys and 3 girls. RESULTS Rigid bronchoscopy could not remove the foreign bodies in bronchi out in 16 cases before thoracotomy. Eleven cases had complications such as pneumonia and/or atelectasis before operation. All the foreign bodies of the 20 cases were non-planted. Most of the cases have a long history. The foreign bodies were successfully removed in 19 patients with thoracotomy, but the location of foreign body in one case changed and couldn＇ t be removed during the thoracotomy and finally removed with rigid bronchoscopy. CONCLUSION Thoracotomy was a useful altemative method in removing the foreign bodies in bronchi with a long history, compilations and special kinds.