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电视辅助胸腔镜肺段切除术后支气管胸膜瘘病例的多学科团队治疗方法:一例报告

Multidisciplinary team approach on a case of bronchopleural fistula after video-assisted thoracoscopic segmentectomy: a case report.

作者信息

Sang Yonghua, Chen Yongbing, Zhang Zengli, Shen Jiucheng, Wang Jun, Zhao Long, Gu Xingshi, Long Cheng, Zhou Liang, Gu Haiyong, Chen Chang

机构信息

Department of Cardiothoracic Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215002, China.

Department of Respiration, The Second Affiliated Hospital of Soochow University, Suzhou 215002, China.

出版信息

Transl Cancer Res. 2020 Jun;9(6):4036-4042. doi: 10.21037/tcr-19-1930.

Abstract

Bronchopleural fistula (BPF) is one of the most severe complications after lung surgery including pneumonectomy, lobectomy, and segmentectomy. BPF is dangerous and complicated. We reported a case of 41-year-old man who underwent a segmentectomy of the right lung through video-assisted thoracoscopy. The patient was diagnosed with BPFs by CT and the symptom of fever, cough with malodorous yellow phlegm. The patient underwent CT-guided thoracic catheter drainage treatment, as advised by a multidisciplinary team including experts from the thoracic surgery department, respiratory medicine department, and interventional department. Later, the patient underwent assisted postural drainage in combination with anti-infection treatment and nutritional support treatment. The patient recovered well. The patient's symptoms were completely relieved. The bronchial stump fistula healed, and the chest abscess disappeared.

摘要

支气管胸膜瘘(BPF)是肺切除术后(包括全肺切除术、肺叶切除术和肺段切除术)最严重的并发症之一。BPF危险且复杂。我们报告了一例41岁男性患者,该患者通过电视辅助胸腔镜进行了右肺段切除术。患者通过CT以及发热、咳嗽伴恶臭黄色痰液的症状被诊断为BPF。按照包括胸外科、呼吸内科和介入科专家在内的多学科团队的建议,该患者接受了CT引导下的胸腔导管引流治疗。随后,患者接受了辅助体位引流,同时进行抗感染治疗和营养支持治疗。患者恢复良好。患者症状完全缓解。支气管残端瘘愈合,胸腔脓肿消失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a39/8797921/4b9d636ffeb5/tcr-09-06-4036-f1.jpg

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