Zhang Bao-shi, Yu Chang-hai, Liu Ying, Xia Hui, Li Ying-jie, Guo Nan-nan
Department of Cardiothoracic Surgery, First Affiliated Hospital, General Hospital of PLA, Beijing 100048, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 May;30(5):1147-9.
To investigate the method of early surgical treatment of bronchopleural fistula after pneumonectomy.
Twelve patients (9 males and 3 females with a mean age of 58.6-/+5.7 years) with bronchopleural fistula after pneumonectomy received a reoperation within 72 h after a definite diagnosis. Empyema was found in none of the 12 cases. Fistula occurred within 4 to 17 days (8 days in average) after the operation. The fistula of the residual main bronchus was resected, and the thoracic cavity was asepticized by flushing.
Ten patients were discharged with complete healing. One patient was discharged following open drainage with daily change of the wound dress. One patient died due to multiple organ failure. The hospital stay of the patients ranged from 18 to 49 days (31 days in average) after the reoperation.
Bronchopleural fistula after pneumonectomy, in case that empyema and multiple organ failure do not occur, can be healed by closing the fistula with the stapling device in early stage. Flushing the thoracic cavity is also necessary after the reoperation.
探讨肺切除术后支气管胸膜瘘的早期外科治疗方法。
12例肺切除术后发生支气管胸膜瘘的患者（男9例，女3例，平均年龄58.6±5.7岁）在明确诊断后72小时内接受再次手术。12例患者均未发现脓胸。瘘发生在术后4至17天（平均8天）。切除残留主支气管的瘘口，并用冲洗液对胸腔进行无菌处理。
10例患者痊愈出院。1例患者经开放引流，每日更换伤口敷料后出院。1例患者因多器官功能衰竭死亡。再次手术后患者的住院时间为18至49天（平均31天）。
肺切除术后支气管胸膜瘘，在未发生脓胸和多器官功能衰竭的情况下，可早期用吻合器闭合瘘口治愈。再次手术后冲洗胸腔也是必要的。
