气管支气管成形术在气管外科中的应用  

APPLICATION OF TRACHEOBRONCHOPLASTY IN TRACHEAL SURGERY

作　　者：段德溥[1] 姜利 杨可贤 信德和[1] 张绍明[1] 张珩[1] 任犹骏 才志刚[1] 吴胜勇[1] 李玉萍[1] 

机构地区：[1]中国人民解放军第四五五医院胸心外科

出　　处：《中国癌症杂志》1998年第2期132-134,共3页China Oncology

摘　　要：目的探讨气管成形术新的术式在气管外科中的应用价值。方法对部位不同的气管、支气管病变施行不同术式的气管或支气管成形术２２例。其中１例气管鳞癌５ｃｍ×３ｃｍ×３ｃｍ，切除肿瘤后用右肺上叶的叶及段支气管纵行剖开缝合成扇形，向上翻转与气管缺损缝合修复，获得成功。１例广泛性气管、右总支气管、中间支气管结核伴重度气道狭窄，采用纵行剖开病变气管、右总支气管及中间支气管，将剖开的右总支气管和中间支气管向上翻转与气管纵行剖开面对应缝合成形，获得成功。结果手术成功２１例，死亡１例（４．５％）。结论对较大范围气管缺损采用自体健康的支气管材料设计不同方案进行修复成形手术，可较其他修复材料（心包。おURPOSE To study the practical value of new modes of tracheoplasty in tracheal surgery.METHODS 22 patients with tracheobronchial pathological lesion at different area were operated on at our hospital by different modes of tracheoplasty and bronchoplasty. There was a patient suffering from squamous cell carcinoma(5 cm×3 cm×3 cm) of trachea.After surgical resection of the tracheal tumor, the lobar and segmental bronchi of right upper lung were longitudinally cut. The contiguous parts of each segmental bronchus were sutured together to form a fanshaped flap,which was turned up and anastomosed with the corresponding parts of tracheal defect. Another patient had widespread tuberculosis of the trachea,right main bronchus and intermediate bronchus accompanying by severe airway stenosis. Longitudinal cutting of the whole diseased trachea,right main bronchus and intermediate bronchus was undertaken.And then,the cutting right main bronchus and intermediate bronchus were turned up and anastomosed satisfactorily with the corresponding longitudinally cutting parts of trachea.The operations were successful.RESULTS Surgery was successful in 21 patients. One patient died(4.5%).CONCLUSION As for larger area of tracheal defect, the adoption of healthy autogenous bronchial tissue together with a scheme of different modes of operation during tracheobronchoplasty would offer much better result than the uses of other reparable materials(pericardium,vascular pedicled periosteum etc.) or the transplantation by artificial trachea.

关 键 词：气管肿瘤 气管成形术 支气管肿瘤 

分 类 号：R653.05[医药卫生—外科学] R734.105[医药卫生—临床医学]