全肺切除术后并发支气管胸膜瘘的处理

Surgical treatment of bronchopleural fistula after total pneumonectomy

目的探讨全肺切除术后合并支气管胸膜瘘的处理方法。方法总结３２例全肺切除术后合并支气管胸膜瘘６例的处理经验并结合文献复习进行讨论。结果６例患者曾反复接受手术治疗。６例中支气管瘘完全愈合、脓腔消失者４例：１例带小支气管瘘及胸壁瘘道院外治疗，最终治愈：１例死于慢性消耗与对侧脓毒性肺炎，死亡率１６．７％（１／６）。结论同时兼顾消毒、消灭脓腔与采取措施闭合瘘口是必要的。

Objective To review the experience of surgical troatffient of bronchopleural fistula after one side total pneumonectomy.Method Of 32 patients underwent total pneumonectomy, 6 cases of bronchopleural fistula were retrospectively studied andliteratures about it were reviewed. Results In the 6 patients who repeatedly underwent operation for the fistula 4 were healed withcomplete disappearance of the abscess cavity and the fistula; One with a small bronchopleural fistula and thoracic fistula was treatedoutside our hospital and finally cured; One patient died of chronic failure and opposite septic pneumonia and the mortality rate was16.7%. Conclusion it is necessary to disinfect, vanish the abscess cavity and close the. fistula at the same time, which are mutuallyinteractive.