Leinung Steffen, Möbius Christian, Hofmann Hans-Stefan, Ott Rudolf, Rüffert Henrik, Schuster Ernst, Eichfeld Uwe
Thoracic Surgery Unit, Centre of Surgery, University of Leipzig, Germany.
Interact Cardiovasc Thorac Surg. 2006 Jun;5(3):303-6. doi: 10.1510/icvts.2005.117242. Epub 2006 Mar 14.
In the present paper we discuss the indication and follow-up of 42 patients with iatrogenic tracheobrochial ruptures. Thirty-five patients were treated by operation and 7 patients were treated conservatively. In the operated patients, four developed an insufficiency of the tracheal closure and the rupture related mortality was 2.8%. A significant effect on suture dehiscence was seen for mediastinitis (P<0.005) prior to operation, prior resection of the esophagus (P<0.001), and a long delay between injury and diagnosis (P=0.004). In the conservatively treated group the rupture related mortality was 29%. In conclusion to our results we suggest a surgical procedure whenever a tracheobronchial rupture is diagnosed and the patient's constitution allows the surgical procedure or anesthesia.
在本文中，我们讨论了42例医源性气管支气管破裂患者的适应症及随访情况。35例患者接受了手术治疗，7例患者接受了保守治疗。在接受手术的患者中，4例出现气管闭合不全，破裂相关死亡率为2.8%。术前纵隔炎（P<0.005）、术前食管切除术（P<0.001）以及损伤与诊断之间的长时间延迟（P=0.004）对缝线裂开有显著影响。在保守治疗组中，破裂相关死亡率为29%。根据我们的结果，我们建议一旦诊断出气管支气管破裂，且患者体质允许进行手术或麻醉，就应采取手术治疗。
