Aydemir Bülent, Imamoğlu Oya Uncu, Ustaalioğlu Recep, Okay Tamer, Doğusoy Ilgaz
Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey.
Ulus Travma Acil Cerrahi Derg. 2011 Jan;17(1):41-5. doi: 10.5505/tjtes.2011.32391.
We aimed in this study to investigate and compare the diagnostic and therapeutic methods in tracheobronchial injuries.
Nine cases (7 male, 2 female) operated between 2003 and 2008 because of tracheobronchial injury were included in the study. The cause of tracheobronchial injury was trauma in 7 cases and postintubation laceration in 2 cases. The cases were evaluated in terms of age, sex, type of trauma, clinical findings, localization of injury, performed diagnostic and therapeutic methods, and results.
The causes of tracheobronchial laceration were blunt trauma in 6 cases, penetrating trauma in 1 case and iatrogenic (postintubation) in 2 cases. Lacerations were in the trachea in 5 cases and at the bronchial level in 4 cases. Operations included right upper bilobectomy in 1 case, tracheal resection and end to end anastomosis in 1 case, end to end anastomosis in 3 cases, and primary repair in 4 cases. One case died during the operation and 1 case died postoperatively.
In tracheobronchial injuries, early diagnosis and treatment are very important. The most useful method is bronchoscopy for determining the type and localization of the injury. In treatment, primary repair should be preferred over anatomical resections whenever possible.
本研究旨在调查和比较气管支气管损伤的诊断和治疗方法。
本研究纳入了2003年至2008年间因气管支气管损伤而接受手术的9例患者(7例男性,2例女性)。气管支气管损伤的原因包括7例创伤和2例插管后撕裂伤。对这些病例在年龄、性别、创伤类型、临床表现、损伤部位、所采用的诊断和治疗方法以及结果等方面进行了评估。
气管支气管撕裂伤的原因包括6例钝性创伤、1例穿透性创伤和2例医源性(插管后)创伤。5例损伤位于气管,4例位于支气管水平。手术包括1例右上叶双肺叶切除术、1例气管切除端端吻合术、3例端端吻合术和4例一期修复术。1例患者在手术期间死亡,1例患者术后死亡。
在气管支气管损伤中,早期诊断和治疗非常重要。确定损伤类型和部位最有用的方法是支气管镜检查。在治疗方面,只要有可能,应优先选择一期修复而非解剖性切除。