石碳酸经纤维支气管镜滴注治疗支气管胸膜瘘  

Treatment of Bronchopleural Fistula by Carbolic Acid via Bronchofiberscope

作　　者：王征[1] 玉寒冰[1] 罗全[1] 

机构地区：[1]辽宁省肿瘤医院胸外科,沈阳110042

出　　处：《中国胸心血管外科临床杂志》2013年第1期78-80,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的分析经纤维支气管镜注入100%石碳酸溶液治疗支气管胸膜瘘的疗效。方法回顾性分析辽宁省肿瘤医院2009年2月至2012年3月术后并发支气管胸膜瘘患者12例的临床资料,其中男11例,女1例;年龄58.0(45～71)岁;全组患者均为原发性肺癌,其中鳞癌8例,腺癌4例;中心型肺癌8例,周围型肺癌4例;3例行右全肺切除术,6例行左全肺切除术,2例行右肺中下叶切除术,1例行左肺上叶切除术。患者经纤维支气管镜滴注100%石碳酸溶液,每次0.5～1.0 ml滴至支气管胸膜瘘黏膜处,观察胸腔闭式引流管气体溢出情况,若1周后仍有气体溢出可反复注射。分析其疗效。结果 12例患者有8例经5次石碳酸滴注后瘘口闭合,2例经过7次,2例经过2次治疗后瘘口闭合。瘘口平均闭合时间33 d,除2例患者因体弱分别住院42 d和50 d外,其余患者均于门诊治疗痊愈,总有效率100%。结论经纤维支气管镜瘘口内滴注100%石碳酸溶液治疗支气管胸膜瘘疗效确切。Objective To evaluate the effect of 100% carbolic acid via bronchofiberscope for the treatment ofbron- chopleural fistula. Methods We retrospectively analyzed clinical data of 12 patients with postoperative bronchopleural fistula in Liaoning Tumor Hospital from February 2009 to March 2012. There were 11 male patients and 1 female patient with their average age of 58.0 （45-71） years. All the patients had primary lung cancer, including squamous cell carcinoma in 8 patients and adenocarcinoma in 4 patients, central lung cancer in 8 patients and peripheral lung cancer in 4 patients. Three patients were alter right total pneumonectomy, 6 patients were alter left total pneumonectomy, 2 patients were alter right middle and lower lobectomy, and 1 patient was after left upper lobectomy. All the patients received 100% carbolic acid instillation via bronchofiberscope, and 0.5-1.0 ml carbolic acid solution was instilled on the mucosal surface around the fistula each time. The presence of bubbles in thoracic drainage was observed. If some bubbles remained, such treatment was repeated after 1 week. The effectiveness was analyzed. Results All the 12 patients were cured after carbolic acid treatment, including 8 patients after 5 times of carbolic acid instillation, 2 patients after 7 times of carbolic acid instillation, and 2 patients after 2 times of carbolic acid instillation. The average time for fistula closure was 33 days. All the patients were treated in our outpatient clinic except 2 patients who were too weak but cured after 42 days and 50 days of hospitaliza- tion respectively. Conclusion The use of 100% carbolic acid instillation via bronchofiberscope can provide satisfactory clinical outcomes for the treatment of bronchopleural fistula.

关 键 词：石碳酸 纤维支气管镜 支气管胸膜瘘 

分 类 号：R734.2[医药卫生—肿瘤]