外伤性肺不张与支气管断裂(附19例报告及文献复习)  

ATELECTASIS OF TRAUMA AND BRONCHIAL INJURIES:A REPORT OF 19 CASES AND LITERATURE REVIEW

作　　者：陈朝晖[1] 杨玉[1] 吴瑞锋[1] 刘钢[1] 甄晨光[1] 刘昌杰[1] 

机构地区：[1]河北省安国市医院胸外科,071200

出　　处：《中国煤炭工业医学杂志》2005年第1期14-16,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的　探讨外伤性肺不张与支气管断裂的诊断和治疗措施。方法　 1 996年 1 2月— 2 0 0 3年 8月收治重症胸部创伤并发肺不张1 9例 ,其中右肺下叶不张 1 0例 ,左肺下叶不张 6例 ,右侧中下叶肺不张 2例 ,右全肺不张 1例 ;1 7例次行支气管镜检查及支气管吸痰肺泡灌洗治疗 ,3例支气管断裂中 ,1例为支气管不全断裂 ,2例手术治疗。结果　本组保守治疗 1 6例 ,手术治疗 3例。治愈 1 8例 ,因ARDS、呼吸衰竭死亡 1例。结论　重症胸部创伤后肺不张无特异临床表现 ,非支气管断裂性外伤性肺不张均易治疗痊愈 ;应高度重视创伤后持久的肺不张 ,纤维支气管镜及影像检查是诊断支气管断裂的可靠方法。Objective To review the diagnosis and treatment for atelectasis of trauma and bronchial injuries. Methods From December 1996 to August 2003,19 cases with major blunt chest trauma combined atelectasis were treated, which were right lower lobe(10),left lower lobe(6),right middle and lower lobe(2),right lung(1). Of which, 17 patients were examined by flexible bronchoscopy and bronchoalveolar lavage. Of 3 cases with bronchial disruption, there were 2 patients treated with operation, and 1 with incompleteness bronchial disruption. Results In the group, only 1 died of ARDS and respiratory failure. Of 18 cured patients, 15 were treated with non-operation and 3 treated with operation. Conclusion Atlectasis dued major blunt chest trauma lack of clinical characteristic, but trauma atelectasis caused by non-bronchial disruption is easily cured. So we should thought much of persistent trauma atelechasis, and the liberal use of flexible bronchoscopy and chest X-ray or CT examination are important in diagnosis of tracheobronchial injuries.

关 键 词：胸部创伤 肺不张 支气管断裂 

分 类 号：R655.3[医药卫生—外科学]