经鼻胸膜腔灌洗治疗肺叶切除术后支气管胸膜瘘的病例对照研究

Endobronchial Naso-bronchial Lavage for Post-lobectomy Bronchopleural Fistula:A Case Control Study

目的评价一种治疗肺叶切除术后支气管胸膜瘘新方法的疗效及安全性。方法回顾性分析长征医院2000。2013年肺叶切除术后支气管胸膜瘘患者20例的临床资料，其中男12例、女8例，平均年龄（67．7±8．7）岁。10例使用经鼻胸膜腔灌洗（ENBL胎疗为ENBL组，另外10例通过传统的胸膜腔引流（TDT）治疗的为TDT组。结果ENBL组比TDT组住院时间短【（49．7±9．6）dvs．（68．3±9．8）d，P〈0．001】，瘘口封闭时间也缩短[（43．7±9．7）dVS．（62．6±8．8）d，P〈0．001】。且ENBL组并发症减少，炎症反应减弱，恢复更好。结论经鼻胸膜腔灌洗治疗肺叶切除术后支气管胸膜瘘效果好，可行。

Objective To evaluate effect and safety of a novel conservative therapy for post-lobectomy broncho- pleural fistula. Methods We retrospectively analyzed the clinical data of 20 patients with post-lobectomy bronchopleural fistula in our hospital between 2000 and 2013 year. There were 12 males and 8 females at average age of 67.7±8.7 years. Endobronchial naso-bronchial lavage （ENBL） was used for 10 patients （an ENBL group）. Traditional method-thoracostomy drainage tube （TDT） was used for the other 10 patients （a TDT group）. Results Compared with the TDT group, shorter hospital day was found in the ENBL group （49,7±9.6 d versus 68.3±9.8 d, P〈0.001）. Fistula healing time was also shorter in the ENBL group than that in the TDT group （43.7±9.7 d versus 62.6±8.8 d, P〈0.001）. There were lower complication rate, less inflammatory reaction, and better recovery in the ENBL group than those in the TDT group. Conclusion ENBL may be a promising procedure for post-lobectomy bronchopleural fistula.