纤维支气管镜在创伤性血气胸中的应用  

The application of fiberoptic bronchoscope examination in traumatic hemopneumothorax

作　　者：郑国刚[1] 高继良[1] 张淑娟[1] 杨业超[1] 

机构地区：[1]天津市蓟县人民医院心胸外科,天津301900

出　　处：《武警医学院学报》2010年第4期298-299,共2页Acta Academiae Medicinae CPAPF

摘　　要：【目的】探讨纤维支气管镜在创伤性血气胸诊治中的应用。【方法】选取我院2007年3月-2009年11月132例创伤性血气胸患者随机分成两组:纤支镜组(F)和对照组(C),每组66例。F组应用纤维支气管镜进行诊治;C组只行胸腔闭式引流术。比较两组再手术率及术前准备时间。【结果】F组明确诊断肺裂伤12例、膈肌破裂1例及心脏破裂1例。除9例表浅肺裂伤应用生物蛋白胶治愈,其余病例立即入手术室治疗,术前准备时间平均(24.70±3.68)min。C组12例入手术室再次手术,术前准备时间平均(85.76±30.22)min。经过统计学对比,F组再手术例数及术前准备时间均少于C组(P<0.05)。【结论】局麻下纤支镜诊治创伤性血气简单、安全,有利于明确病因。表浅的肺裂伤可以同时给予治疗,使许多患者免去剖胸手术风险。[Objective]To evaluate the clinical value of thoracoscopy in traumatic hemopneumothorax with fiberopticbronchoscopy.[Methods]From May 2007 to Nov. 2009,a total of 132 patients were clinically suspected as traumatic hemopneumothorax were studied. They were divided into 2 groups：F （n=66,experimental group） through the cutting edges of closed chest drainage or perforating wound,the pleural cavities could be observed clearly. Simultaneously a control group that included 66 suspcted hemopneumothorax patients was set up.[Results]Among the group with fiberopticbronchoscopy,rupture of pulmonary in 12,rupture of the diaphragm in 1,cardiac rupture in 1,were recovered well after emergency operation. 9 patients with slight pulmonary injury was treated by fiberopticbronchoscopy. The group with fiberopticbronchoscopy pre-operative prepration time （24.70±3.68）were significant shorter than those group without fiberopticbronchoscopy （85.76±30.22） min.[Conclusion]It is a safe,easy and effective method to apply fiberopticbronchoscopy for the patients of hemopneumothorax. under local anesthesia. It may allow many patients to avoid remove the risk of undergo emergency thoracotomy..

关 键 词：纤维支气管镜 诊治 血气胸 胸腔闭式引流术 

分 类 号：R561[医药卫生—呼吸系统]