Sueda T, Matsuura Y, Ishihara H, Hamanaka Y, Kanehiro K, Hayashi S, Ishihara S
Kyobu Geka. 1989 Nov;42(12):1021-4; discussion 1024.
A case of right bronchial disruption caused by blunt chest trauma was successfully operated. Patient is a 35-year-old woman who was transferred to our intensive care unit with markedly dyspnea and subcutaneous emphysema. Rupture of right bronchus was suspected by chest x-ray film and bronchial fiberscopy. An emergency thoracotomy was performed with the aid of selective lung ventilation by the use of double lumen endobronchial tube. Right bronchus was completely transected and small part of upper lobe was lacerated. Right bronchus was anastomosed directly with interrupted 3-0 vinyl sutures and laceration of upper lobe was sutured. Postoperative course was uneventful, but postoperative bronchoscopy confirmed slight stenosis of the anastomotic position. Prompt diagnosis by bronchoscopy and emergency thoracotomy followed by selective lung ventilation are mandatory in this patient survival.
一例因钝性胸部创伤导致右支气管断裂的病例成功进行了手术。患者为一名35岁女性,因明显呼吸困难和皮下气肿被转入我们的重症监护病房。胸部X光片和支气管纤维镜检查怀疑右支气管破裂。在使用双腔支气管导管进行选择性肺通气的辅助下进行了紧急开胸手术。右支气管完全横断,上叶一小部分撕裂。用3-0乙烯基缝线间断直接吻合右支气管,并缝合上叶撕裂处。术后过程顺利,但术后支气管镜检查证实吻合部位有轻微狭窄。对于该患者的存活,通过支气管镜检查进行快速诊断、紧急开胸手术并随后进行选择性肺通气是必不可少的。