流弹爆炸致肺破片伤急诊胸腔镜手术救治体会并文献复习  

Experience and literature review in emergency video-assisted thoracoscopic surgery for projectile injuries in the lung caused by stray bullet explosion

作　　者：徐同毅 王云 范韶玮 李浩 黎涛 XU Tongyi;WANG Yun;FAN Shaowei;LI Hao;LI Tao(Department of Cardiovascular and Thoracic Surgery,No.971 Hospital of PLA Navy,Qingdao,Shandong Province,266071,China)

机构地区：[1]解放军海军第九七一医院心血管胸外科,山东青岛266071

出　　处：《第三军医大学学报》2021年第17期1703-1706,F0003,共5页Journal of Third Military Medical University

基　　金：全军后勤科研重大项目(AWS14C003);青岛市卫健委科研计划(2019-WJZD162)。

摘　　要：目的探讨胸腔镜微创手术在爆炸致肺破片伤紧急救治中的应用。方法2020年12月收治1例流弹爆炸致左下肺破片伤患者,经过肺三维重建和心脏超声检查及完善术前评估后,急诊行胸腔镜下右肺下叶楔形切除术+右侧血胸清除术+右侧胸壁伤口扩创术。结果患者手术顺利,抢救成功,2周后恢复出院,随访2个月无明显并发症,肺内伤道血肿和炎症明显吸收。结论胸腔镜微创手术能够应用于爆炸致肺破片伤紧急救治,为胸部战伤微创紧急救治提供支持。Objective To investigate the application of video-assisted thoracoscopic(VATS)surgery in emergency treatment of projectile injuries in the lung caused by explosion.Methods A case of projectile injury shot in the left lower lung by a stray bullet was admitted in our department in December 2020.After three-dimensional reconstruction of lung CT images,echocardioghaphy and other preoperative evaluations,emergency VATS wedge resection of the right inferior lobe,right hemothorax removal and right chest wall wound enlargement surgery were performed.Results The patient was successfully rescued and discharged from our hospital after surgery,and no significant complication was observed at 2 months after follow-up.The hematoma and inflammation along the projectile in the lung were obviously absorbed.Conclusion The VATS surgery can be used in the emergency treatment of projectile injuries in the lung caused by explosion,and provides support for the minimally invasive emergency treatment of war wounds of the chest.

关 键 词：爆炸肺破片伤 胸腔镜 急诊手术 

分 类 号：R443.8[医药卫生—诊断学] R655.3[医药卫生—临床医学]