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支气管扩张症的外科治疗:138 例回顾性观察研究。

Surgical treatment of bronchiectasis: a retrospective observational study of 138 patients.

机构信息

Department of Cardiothoracic Surgery, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Egypt.

出版信息

J Thorac Dis. 2013 Jun;5(3):228-33. doi: 10.3978/j.issn.2072-1439.2013.04.11.

Abstract

BACKGROUND

We analyzed cases of bronchiectasis; its presentation, etiology, diagnosis, indications for surgery, surgical approach, and the outcome.

METHODS

A retrospective analysis of 138 patients who underwent surgery for bronchiectasis.

RESULTS

The mean age was 30.2±15.7 years. 55.8% patients were males. Symptoms were recurrent infection with cough in all patients, fetid sputum (79.7%), and hemoptysis (22.5%). The etiology was recurrent childhood infection (38.4%), pneumonia (29%), TB (9.4%), sequestration (4.3%), foreign body obstruction (4.3%), and unknown etiology (14.5%). CXR, CT scan, and bronchoscope were done for all patients. Bronchiectasis was left-sided in (55.1%) of patients. It was mainly confined to the lower lobes either alone (50.7%) or in conjunction with middle lobe or lingual (7.2%). Indications for resection were failure of conservative therapy (71.7%), hemoptysis (15.9%), destroyed lung (8%), and sequestration (4.3%). Surgery was lobectomy (81.2%), bilobectomy (8.7%), and pneumonectomy (8%). Complications occurred in 13% with no operative mortality. 84% of patients had relief of their preoperative symptoms.

CONCLUSIONS

Surgery for bronchiectasis can be performed with acceptable morbidity and mortality at any age for localized disease. Proper selection and preparation of the patients and complete resection of the involved sites are required for the optimum control of symptoms and better outcomes.

摘要

背景

我们分析了支气管扩张症的病例;其表现、病因、诊断、手术适应证、手术方法和结果。

方法

对 138 例因支气管扩张症而行手术的患者进行回顾性分析。

结果

平均年龄为 30.2±15.7 岁。55.8%的患者为男性。所有患者均有反复感染、咳嗽、恶臭痰(79.7%)和咯血(22.5%)的症状。病因是反复儿童感染(38.4%)、肺炎(29%)、TB(9.4%)、隔离肺(4.3%)、异物阻塞(4.3%)和不明原因(14.5%)。所有患者均行 X 线胸片、CT 扫描和支气管镜检查。左侧支气管扩张占(55.1%)的患者。主要局限于下叶,单独存在(50.7%)或与中叶或舌叶并存(7.2%)。切除的适应证为保守治疗失败(71.7%)、咯血(15.9%)、肺破坏(8%)和隔离肺(4.3%)。手术方式为肺叶切除术(81.2%)、双肺叶切除术(8.7%)和肺切除术(8%)。并发症发生率为 13%,无手术死亡。84%的患者术前症状缓解。

结论

对于局限性病变,支气管扩张症手术可在任何年龄进行,具有可接受的发病率和死亡率。为了获得最佳的症状控制和更好的结果,需要对患者进行适当的选择和准备,并进行受累部位的彻底切除。

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