Gwely Noureldin Noaman
Mansoura University Hospital Mansoura, Egypt.
Asian Cardiovasc Thorac Ann. 2009 Dec;17(6):598-603. doi: 10.1177/0218492309349067.
The aim of this study was to evaluate our results of management of bronchial rupture after blunt chest trauma in young patients. Between January 2000 and December 2007, 34 patients aged 6-18-years old were treated for bronchial rupture; 25 presented early and 9 presented late. The 21 (62%) boys and 13 (38%) girls had a mean age of 11.58 +/- 2.51 years. Radiography, computed tomography, and rigid bronchoscopy were performed in stable acute cases and late-presenting cases, with rapid bronchoscopy followed by thoracotomy in urgent cases. In the patients who presented early, repair was undertaken through a right thoracotomy in 21 (84%) and via a left thoracotomy in 4 (16%). Direct suturing was carried out in all except 3 patients who needed lobectomy. Reimplantation of the main bronchus after debridement of the edges was possible in 4 (44%) of the chronic cases, and pulmonary resection was required in 5 (56%). Four (11.8%) patients died due to perioperative cardiac arrest and cerebral hypoxia with failure of resuscitation. Meticulous collaboration between the surgeon and anesthetist is important to ensure survival.
本研究的目的是评估我们对年轻患者钝性胸部创伤后支气管破裂的治疗结果。2000年1月至2007年12月期间,34例6 - 18岁的患者因支气管破裂接受治疗;25例为早期就诊,9例为晚期就诊。其中21例(62%)为男孩,13例(38%)为女孩,平均年龄为11.58±2.51岁。对于病情稳定的急性病例和晚期就诊病例,进行了X线摄影、计算机断层扫描和硬质支气管镜检查,对于紧急病例则先进行快速支气管镜检查,随后进行开胸手术。在早期就诊的患者中,21例(84%)通过右胸开胸手术进行修复,4例(16%)通过左胸开胸手术进行修复。除3例需要肺叶切除术的患者外,其余均进行了直接缝合。在4例(44%)慢性病例中,对边缘清创后可行主支气管再植术,5例(56%)需要进行肺切除术。4例(11.8%)患者因围手术期心脏骤停和脑缺氧且复苏失败而死亡。外科医生和麻醉师之间的密切协作对于确保患者存活至关重要。