肺切除术后支气管胸膜瘘19例临床分析
肺切除;,支气管胸膜瘘;,分析,,肺切除;,支气管胸膜瘘;,分析,1资料与方法,2结果,3讨论,参考文献:
摘要：目的：探讨肺切除术后支气管胸膜瘘的特点和诊治经验。方法：对19例肺切除术后支气管胸膜瘘患者的临床资料进行回顾性分析，19例中8例行胸腔冲洗引流、抗炎、营养支持等保守治疗，4例行纤支镜、胸腔镜纤维蛋白胶封堵，7例行手术治疗，其中5例行肺叶切除，2例行瘘口切除修补。结果：8例保守治疗者痊愈6例，死亡2例。4例纤支镜、胸腔镜纤维蛋白胶封堵者均痊愈。手术治疗7例中4例痊愈，3例再次发生支气管胸膜瘘，其中手术治疗1例死亡，保守治疗2例中死亡1例。19例中共死亡4例(21%)。结论：体型消瘦者和术前、后放、化疗及全肺切除、再次手术的患者可能更容易发生肺切除术后支气管胸膜瘘，采取补救方法如带蒂胸膜片等包埋支气管残端有可能降低支气管胸膜瘘发生的危险。关键词：肺切除; 支气管胸膜瘘; 分析
Clinical analysis of the patients with bronchopleural fistula after pneumonectomyWU Bin, ZHANG Guoqing, GAO Shengli, et al
(Department of Thoracic Surgery, Affiliated Cancer Hospital, Xinjiang Medical University,
Urumqi 830011, China)Abstract: Objective: To explore the experience of the therapy on the patients with bronchopleural fistula after pneumonectomy. Methods: To analize 19 patients treated during Jan, 1989 to Jan, 2006. retrospectively, All of the cases in the group were older patients with low albumin, of all the cases, 8 cases were given conservative treatment such as closed drainage, pleuroclysis, antiinflammatory therapy, and supportive treatment. Four cases were closed off by bronchoscope and mediastinoscopy and 7 cases were operated. Results: Two out of 8 cases of conservative treatment and 2 out of 7 cases of operative treatment were dead, the total mortality rate were 21%(4/19). Three cases regain sufferance from bronchial fistula postoperatively. Conclusions: Slim ,total pneumonectomy, lower pulmonary lobectomy, perioperative radiotherapy and chemotherapy, are high risk factors of bronchopleural fistula after pneumonectomy. We should take measures such as encapsulate bronchial section with pleura to reduce the occurance of bronchopleural fistula. ......
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