论文部分内容阅读
目的：总结肺切除术后支气管胸膜瘘的临床诊断和治疗经验。方法回顾性分析30例肺切除术后支气管胸膜瘘患者的病例资料,采取胸腔闭式引流、胸腔冲洗、纤支镜生物胶封堵、瘘口修补加组织包埋、胸膜余肺切除、胸廓成形术等方法治疗。结果20例瘘口直径小于3mm者,早期13例直接二次手术,9例获得治愈,4例再次出现瘘口,后采取胸廓成形术治疗；后期7例在纤支镜下采用生物胶封堵处理均治愈。10例瘘口直径大于3mm者,2例生物胶封堵治疗无效后长期引流,治愈6例,其余4例因严重感染和呼吸衰竭等原因而死亡。结论支气管胸膜瘘重在预防,治疗关键在于封闭瘘口,彻底消灭脓腔。“,”Objective To summarize the clinical experience of diagnosis and treatment of bronchopleural fistula after pneumonectomy.Methods The clinical data of 30 patients with bronchopleural fistula after pneumonectomy were retrospective analyzed.The closed drainage of thoracic cavity,pleural lavage,bronchoscopy biological glue sealing,fistula mending plus tissue embedding,pleural remaining-pulmonary resection,thoracoplasty were adopted to treat.Results 20 cases of fistula diameter less than 3mm, early 13 cases directly two times operation,9 cases were cured,4 cases of fistula happened again,take thoracoplasty treated late.7 cases were cured by biological glue sealing treatment in fibrobronchoscopy.10 cases of fistula diameter greater than 3mm,2 cases of long-term drainage invalid biological glue sealing treatment, 6 cases were cured,4 cases died of other serious infections and respiratory failure and other reasons.Conclusion The focus of bronchopleural fistula was prevention,and the key of treatment was close fistula,wipe out the pus cavity.