肺部手术后支气管胸膜瘘的临床分析

发布时间：2018-06-22 02:30

本文选题：肺部手术 + 支气管胸膜瘘　；参考：《中南大学学报(医学版)》2017年10期

【摘要】：目的:探讨肺部手术后支气管胸膜瘘(bronchopleural fistula,BPF)的危险因素、预防措施及治疗方法。方法:回顾性分析中南大学湘雅医院胸外科2012年4月至2016年6月肺切除术后发生的11例BPF患者的临床资料,分析其临床特点、处理措施及预后,并总结其危险因素及有效的治疗方法。结果:11例BPF患者中,10例痊愈出院,1例死亡,病死率为9.09%。采用积极治疗的10例患者均痊愈出院,其中包括5例行急诊余肺或全肺切除的患者,4例行封堵器或支架治疗的患者,以及1例行生物胶治疗的患者;1例保守治疗的患者最终因呼吸衰竭而死亡。结论:BPF早期的积极干预至关重要。肺切除术后发生的微小瘘可首选纤维支气管镜下生物胶封堵;肺叶切除的患者发生BPF时,若患者条件允许且在纤维支气管镜下无法治愈,应尽早行余肺或全肺切除;全肺切除的患者发生BPF时,可优先考虑纤维支气管镜下放置封堵器或覆膜支架。
[Abstract]:Objective: to investigate the risk factors, prevention and treatment of bronchopleural fistula after pulmonary surgery. Methods: the clinical data of 11 patients with BPF after pneumonectomy in Xiangya Hospital of Central South University from April 2012 to June 2016 were analyzed retrospectively. The risk factors and effective treatment were summarized. Results of 11 BPF patients, 10 cases were cured and 1 case died, the mortality was 9.09%. All of the 10 patients treated with active therapy were cured and discharged, including 5 patients with emergency pulmonary excision or total pneumonectomy, 4 patients with occluder or stent therapy. One patient with biogel therapy and one patient with conservative treatment died of respiratory failure. Conclusion the early positive intervention of BPF is very important. Biogel closure under fiberoptic bronchoscopy was the first choice for small fistula after pneumonectomy, and when BPF occurred in patients with lobectomy, residual lung or total lung resection should be performed as soon as possible if the patient's condition permitted and could not be cured under fiberoptic bronchoscopy. When BPF occurs in patients with total pneumonectomy, it is preferable to place occluder or stent under fiberoptic bronchoscope.
【作者单位】：中南大学湘雅医院胸外科;
【基金】：湖南省自然科学基金(2017JJ2345)~~
【分类号】：R655.3

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