创伤性气管、支气管断裂的诊断与治疗（附17例报告）

目的 探讨创伤性气管、支气管断裂的诊治特点，提高诊断率、治疗效果及思者生成质量。方法 回顾性分析17例创伤性气管、主支气管断裂病人的临床资料。结果 14例行支气管端端吻合术；1例行支气管修补术，术后支气管针尖样狭窄，再行肺叶切除术；1例行气管修补术；1例行狭窄气管切除、气管端端吻合、T形硅胶管置管术。术后行纤维支气管镜检查：早期吻合口水肿狭窄呈裂隙状2例，1月后复查通畅，余均为良好。结论 创伤性支气管断裂容易误诊，纤维支气管镜检查是早期诊断最重要的手段，气管断裂常合并肺动脉干中层结构损伤，在切除狭窄段支气管时瘢痕要切除干净。术后早期应复查纤维支气管镜。

Diagnosis and treatment of traumatic tracheobronchial ruptures: report of 17 cases]

OBJECTIVE: To evaluate the diagnosis and treatment of tracheobronchial ruptures due to thoracic trauma. METHODS: The clinical data of 17 cases of bronchial rupture caused by chest trauma was analyzed retrospectively. The surgical approaches and post-trauma complications were described. RESULTS: End-to-end anastomosis was performed in 14 cases. Among the other 3 patients, one received lobectomy after bronchial repair, another had tracheal repair, and resection of the stenosed segment along with end-to-end anastomosis during thoracotomy was necessitated in the last case. Anastomotic stricture occurred early after the operation in 2 of all these cases, while 2 months postoperatively, all the patients were free from such strictures. CONCLUSION: Early diagnosis and operation in such cases can be life-saving, and may warrant early recovery of the pulmonary function. Accurate diagnoses of bronchial rupture can be obtained by bronchoscopy, with which the surgeons can easily locate the rupture during surgery.