Kirndörfer D, Filler D, Schwemmle K
Prax Klin Pneumol. 1979 Apr;33 Suppl 1:449-51.
Rupture of the major airways is rare. Open injuries usually involve the trachea; injuries to the airways in closed chest trauma are in 80-90% of the cases located at the bifurcation or the main bronchus. Rupture of the bronchial system may cause an immediate threat to life, but may also produce few symptoms. The possibility of such an injury should always be taken into consideration, even if at first the clinical signs only point to damage of the lung parenchyma. Intubation and continuous suction drainage are life-saving emergency measures to be followed as soon as possible by bronchoscopy to establish the diagnosis. Treatment is by prompt suture or anastomosis. Failure to diagnose rupture of a bronchus results very soon in stenosis and, later on, in damage to the lungs and jeopardizes the success of subsequent reconstructive surgery. The repair of extended stenoses presents particularly difficult technical problems. Alloplastic grafts may be the answer. During 1961-1978 7 persons with injuries to the trachea and bronchi were treated at the Department of Surgery, Giessen. 3 persons were saved by immediately performing an anastomosis.
主气道破裂很少见。开放性损伤通常累及气管；闭合性胸部创伤中的气道损伤80% - 90%发生在分叉处或主支气管。支气管系统破裂可能会立即对生命构成威胁，但也可能几乎不产生症状。即使最初临床体征仅提示肺实质损伤，也应始终考虑到这种损伤的可能性。插管和持续吸引引流是挽救生命的紧急措施，随后应尽快进行支气管镜检查以明确诊断。治疗方法是及时缝合或吻合。未能诊断支气管破裂很快会导致狭窄，随后会损害肺部，并危及后续重建手术的成功。修复广泛性狭窄存在特别困难的技术问题。异体移植物可能是解决办法。1961年至1978年期间，吉森外科治疗了7例气管和支气管损伤患者。3例通过立即进行吻合术得以挽救。
