气管支气管破裂的诊断和处理

The diagnosis and treatment of rupture of the trachea and bronchus

目的 评价早、晚期气管、支气管断裂的诊断、治疗特点与动脉血气改变。方法 分析 34例气管、支气管破裂的病例 ,包括气管重建 2例、修补 2例及保守治疗 3例 ,支气管重建 19例 ,全肺切除 6例。术前和术后 2周进行动脉血气分析。结果 2 9例经手术治疗后痊愈 ,4例保守治愈 ,1例拒绝手术。结论 诊断依据胸部外伤史、胸部X线检查和纤维支气管镜检查 ,治疗采取气管、支气管重建术。重建术后出现支气管吻合口狭窄者经再次手术治疗效果仍满意。动脉血气分析显示 ,术后 2周多数患者PaO2 和SaO2

Objective To evaluate the outcome of dagnosis and treatment of early and late stage tracheal and bronchial rupture.?Methods Thirty four cases of tracheal and bronchial rupture were analysed,consisting of 2 patients for tracheal reconstruction, 2 patients for tracheal repair and 3 cases for tracheal conservative treatment,19 cases for bronchial reconstruction, 6 cases for pneumonectomy.All patients' blood gas was analysed before and 2 weeks after operations.?Results Twenty nine cases were cured by operation and 4 by conservative treatment. One refused to be operated. Blood gas analysis resumed normal in most patients 2 weeks after operation.?Conclusion The diagnosis of tracheal and bronchial rupture depends on history of trauma, chest X ray and fiberbronchoscopy. Treatment was based on the tracheal and bronchial reconstruction. The surgical treatment for bronchial anastomotic stenosis following the reconstructive operation was satisfactory. Blood gas analysis revealed that PaO 2 and SaO 2 might be resumed to normal in most patients 2 weeks after operations.