支气管胸膜瘘的外科治疗  

Surgical treatment of bronchus-pleural fistula

作　　者：江南[1] 张卫东[1] JIANG Nan;ZHANG Wei-dong(Department of Thoracic Surgery,Henan Provincial Chest Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省胸科医院胸外科,郑州450003

出　　处：《医药论坛杂志》2023年第7期6-9,共4页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220226)。

摘　　要：目的 探索外科治疗支气管胸膜瘘(BPF)的手术方法和临床疗效。方法 回顾性总结2019年1月至2021年4月河南省胸科医院收治的15例BPF患者的临床资料,分析其治疗方法及疗效,讨论总结治疗心得。结果 1例采用纤维支气管镜下生物胶、纤维蛋白胶封堵后,瘘口愈合。13例分别接受胸廓成形加瘘口修补术、胸膜外全肺切除或余肺切除术、带蒂胸膜或肌瓣包埋气管残端等方法治疗,8例术后完全治愈,3例术后拔除胸管时间延长,最终痊愈,1例因BPF复发,最终死于呼吸衰竭,1例带管出院后失访。结论 BPF一旦确诊,保持胸腔通畅引流及有效冲洗消毒、抗感染治疗及营养支持是治疗的有效措施,而外科手术包括胸膜、带蒂肌瓣等包埋支气管残端是BPF有效的治疗方法。Objective To evaluate the outcomes and surgical management of bronchus-pleural fistula.Methods The clinical data of 15 patients with bronchus-pleural fistula between January 2019 and April 2021 in Henan Provincial Chest Hospital were retrospectively analysed.The treatment strategy and the outcomes were investigated,and the outcomes were summarized.Results 13 patients underwent thoracoplasty with fistula repair,total pneumonectomy or residual pneumonectomy,and pedicle pleura or muscle flap embedding of tracheal stumps.8 patients were completely cured after surgery,3 patients underwent prolonged removal of the thoracic tube,and ultimately recovered.1 patient died of respiratory failure due to recurrence of BPF,and 1 patient was lost after discharge with the drainage tube preserved.Conclusion Once the BPF is diagnosed,maintaining unobstructed drainage,effective chest flushing and disinfection,anti infection treatment,and nutritional support are effective treatment measures,while surgical procedures,including burying bronchial stumps with pleura and pedicled muscle flaps,are effective treatment methods for BPF.

关 键 词：支气管胸膜瘘 外科治疗 肌瓣 带蒂胸膜 

分 类 号：R619[医药卫生—外科学]