钝性胸部外伤致气管支气管裂伤十例报告

rupture due to blunt thoracic trauma： a report of 10 cases

目的探讨钝性胸部外伤所致的气管、支气管断裂的诊治要点，提高早期诊断率、治疗效果及患者生存率。方法回顾性分析我院1990年至2010年间收治的10例钝性胸部外伤所致的气管支气管断裂的病例资料。7例行支气管、气管端端吻合术，1例行气管修补术，2例行狭窄气道切除、支气管端端吻合术。结果术后4例出现了严重感染，住院时间最短20d，最长81d。所有病例术后复查纤支镜，均无异常。结论部分钝性胸部外伤所致的气管支气管断裂极易被误诊，纤支镜与胸部64排CT气管重建能有助于早期诊断。尽早手术治疗与感染的控制是治疗的关键，术后应复查纤支镜了解气道的通畅情况。

Objective To investigate the key point of diagnosis and surgical treatment for tracheobronchial rupture induced by blunt thoracic trauma and to improve the early diagnosis rate, treatment effect and survival rate. Methods A retrospective study was carried out in 10 cases which were treated by our department from 1990 to 2010. End - to - end anastomosis was performed in 7 cases. Among the other 3 cases one received bronchial repair,and two had resection of the stenosed segment along with end -to - end anastomosis. Results Postoperative severe infection occurred in 4 cases. All cases were counter- checked via bronchofiberscope postoperatively,and there were no abnormalities. Conclusion Some cases of tracheobronchial rupture induced by blunt thoracic trauma tend to be misdiagnosed. Bronchofiberscope and trachea rebuilding by thoracic 64 - slice helical CT can help early diagnosis. Early surgical treatment and control of severe infection is the key to the therapy. It is necessary to countercheck the airway via bron- chofiberscope postoperatively.