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目的:分析小儿支气管断裂的原因、分型、临床特点及治疗。方法:全组11例小儿外伤性支气管断裂分别占同期入院小儿胸外伤和外伤性支气管断裂的1.1%和3.2%。小儿外伤性支气管断裂以Ⅱ型多见,占63.6%。其主要临床症状为咳嗽、咯血、皮下气肿。有1/3患儿伤后 X 线胸片无气胸改变,极易误诊。结果:11例皆采用手术治疗,8例行支气管成形术,2例行支气管成形并气管下端侧壁肋间肌瓣修补,1例成形一个月后因吻合口狭窄、肺化脓症行全肺切除。全组除1例因呼吸衰竭死于手术后6小时外,其余10例均痊愈出院。随访中2例失访,8例已存活1～15年。结论:及早正确的诊治、熟练的手术技巧、良好的术后护理是治疗本病的关键。
Objective: To analyze the causes, classification, clinical features and treatment of bronchial rupture in children. Methods: All the 11 cases of pediatric traumatic bronchial rupture accounted for 1.1% and 3.2% of pediatric chest trauma and traumatic bronchial rupture respectively. Pediatric traumatic bronchial rupture to type Ⅱ more common, accounting for 63.6%. The main clinical symptoms of cough, hemoptysis, subcutaneous emphysema. 1/3 of children with X-ray chest injury after pneumoperitoneum changes, easily misdiagnosed. Results: All of the 11 cases were treated by surgery, 8 cases were treated by bronchoplasty, 2 cases were treated by bronchoplasty and intervertebral intercostal muscle flap at the lower end of the trachea, 1 case was diagnosed by anastomosis stenosis and pulmonary pus after one month . In addition to a group of patients died of respiratory failure due to respiratory failure 6 hours after surgery, the remaining 10 patients were discharged. Two patients were lost to follow-up and eight patients survived from 1 to 15 years. Conclusion: The correct diagnosis and treatment as soon as possible, skilled surgical skills, good postoperative care is the key to the treatment of this disease.