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少即是多:保留肺组织的中间支气管创伤性破裂直接修复术

Less is more: lung-sparing direct repair of a traumatic rupture of the bronchus intermedius.

作者信息

Scognamiglio Giovanni, Solli Piergiorgio, Benni Marco, Davoli Fabio, Pardolesi Alessandro, Bertolaccini Luca, Agnoletti Vanni

机构信息

Anaesthesia and Intensive Care, Emergency Department, AUSL Romagna, Maurizio Bufalini Teaching Hospital, Trauma Center, Cesena, Italy.

Department of Thoracic Surgery, AUSL Romagna, Morgagni-Pierantoni Teaching Hospital, Forlì, Italy.

出版信息

J Vis Surg. 2017 Aug 21;3:109. doi: 10.21037/jovs.2017.06.07. eCollection 2017.

Abstract

Major trauma is one of the most common causes of death in the western world in the young population (15-25 years). Thoracic trauma represents 25% of traumatic deaths, and the incidence of tracheobronchial injuries in literature is lower than 5%. Nevertheless, airway injuries are life-threatening conditions. Here we present a case of a 25-year-old patient who underwent a severe motorcycle crash. The injury severity score (ISS) was 35 at admission to the hospital. A right middle bronchus laceration <2 cm involving the whole thickness of the wall of the bronchus intermedius was identified. An urgent right posterolateral thoracotomy was performed, and the lesion was directly repaired. A conservative intervention was the key to grant our patient a healthy life.

摘要

在西方世界,严重创伤是年轻人群(15 - 25岁)最常见的死亡原因之一。胸部创伤占创伤性死亡的25%,而文献中气管支气管损伤的发生率低于5%。然而,气道损伤是危及生命的情况。在此,我们报告一例25岁患者,其遭遇了严重的摩托车事故。入院时损伤严重度评分(ISS)为35分。发现右中间支气管有一处长度小于2 cm的裂伤,累及中间支气管壁全层。急诊行右后外侧开胸手术,并直接修复了损伤部位。保守干预是使我们的患者获得健康生活的关键。

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本文引用的文献

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Traumatic injury to the trachea and bronchus.气管和支气管的创伤性损伤。
Thorac Surg Clin. 2007 Feb;17(1):35-46. doi: 10.1016/j.thorsurg.2007.03.005.
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Operative management and outcomes of traumatic lung resection.创伤性肺切除的手术管理与预后
J Am Coll Surg. 2006 Sep;203(3):336-44. doi: 10.1016/j.jamcollsurg.2006.05.009. Epub 2006 Jul 11.
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Indications for surgery in tracheobronchial ruptures.气管支气管破裂的手术指征。
Eur J Cardiothorac Surg. 2001 Aug;20(2):399-404. doi: 10.1016/s1010-7940(01)00798-9.
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Blunt tracheobronchial injuries: treatment and outcomes.钝性气管支气管损伤:治疗与预后
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