2种支气管残端处理方式对肺癌切除术后并发支气管胸膜瘘的比较

The Effect of Two Bronchi-Closing Methods on Incidence of Bronchopleural Fistula after Lobectomy for Non-Small Cell Lung Cancer

目的:比较间断全层缝合法(Sweet法)与支气管闭合器闭合法对肺癌切除术后支气管胸膜瘘发生的影响。方法:选取120例非小细胞肺癌患者,均行解剖性肺叶切除手术加系统性肺门纵隔淋巴结清扫术,根据支气管残端处理方式的不同分为2组。Sweet法组(n=60)切除时采用间断全层缝合法闭合支气管残端,闭合器组(n=60)采用支气管闭合器处理支气管残端。比较2组病例支气管闭合时间及术后支气管胸膜瘘的发生情况。结果:闭合器组支气管闭合时间为10.55±7.14 min,短于Sweet法组闭合时间31.66±8.76 min(P<0.05)。120例肺切除患者不同支气管残端处理后2组支气管胸膜瘘发生率无显著性差异(P>0.05)。结论:间断全层缝合法和支气管闭合器闭合法在处理肺癌切除术支气管残端时,支气管胸膜瘘的发生情况基本相同,但支气管闭合器闭合支气管速度快、易于掌握,临床上需根据具体病情,结合患者自身经济条件进行选择。

Objective： To compare the effects of two bronchi - closing methods on incidence of bronchopleura] fistula after lobectomy for non -small cell lung cancer. Methods： Lobectomy was performed in patients with non - small cell lung cancer. Two methods of bronchi - closing were applied： bronchi - closing device, simple full - thickness interrupted suture （ Sweet method）. The bronchi - closing time, incidence of bronchopleural fistula were observed and compared between the two groups. Results ： The bronchi - closing time in bronchi - closing device group and Sweet suture group were 10. 55±7. 14 min, 31. 66 ±8.76 rain respectively, with significant statistical difference （ P 〈 0. 05 ）. Incidence of bronchopleural fistula in two groups was 1.67% and 1.67% respectively, no significant statistical difference between the two groups（P 〉0.05 ）. Conclusion： Compare to Sweet method, bronchi- closing device do not reduce occurrence of bronchopleural fistula, but shorten bronchi - closing time. Choice should depend on state of disease and patients＇ economic conditions.