胸外科手术后呼吸衰竭合并支气管胸膜瘘治疗效果观察

The treatment of patients with respiratory failure and bronchopleural fistula after thoracic surgery

目的探讨胸外科手术后呼吸衰竭合并支气管胸膜瘘患者的治疗方法与效果。方法选取2012-09∽2014-03行胸外科手术治疗,术后出现呼吸衰竭合并支气管胸膜瘘患者9例,对其治疗方法与效果进行回顾性分析。结果治愈8例,死亡1例,患者住院治疗时间为18∽32（24.6±1.3）d109例患者治疗24 h后的氧分压、血氧饱和度明显高于治疗前（P〈0.05）;二氧化碳分压明显低于治疗前（P〈0.05）。结论采取有效措施控制患者呼吸衰竭症状,加强营养支持,以改善机体状况后,根据患者具体病情,采取支气管黏膜下注射硬化剂、胸腔内注入生物胶、外科手术等方法行支气管胸膜瘘治疗,能够有效提高救治效果。

Objective To explore the treatment approach and its effect of the treatment on patients with respiratory failure and bronchopleural fistula after thoracic surgery. Methods 9 patients with bronchial BPF were collected from September 2012 to March 2014 in our hospital and were retrospectively analyzed. Results The curative rate is 88. 9%（ 8 cases） and the death rate was 11. 1%（ 1 case）. The average time of hospital stay was（ 24. 6 ±1. 3） days,from 18 to 32 days. The oxygen partial pressure and blood oxygen saturation monitoring values were significantly higher after the treatment of 24 hours than those before the treatment. Partial pressure of carbon dioxide after the treatment was lower than that before the treatment（ P〈0. 05）. Conclusion Comprehensive and effective measures should be carried out to control the symptoms of patients with respiratory failure,strengthen nutrition support,improve the body heath condition,and take the bronchial submucosal injection of hardener,chest cavity injection of xanthan gum,BPF treatment and surgical methods according to the specific patient.