肺叶切除术后12例支气管胸膜瘘临床分析

摘要

目的：探讨肺叶切除术后支气管胸膜瘘（bronchopleural leakage，BPL）的治疗方法。方法：回顾性分析12例肺叶切除术后支气管胸膜瘘患者的临床资料：分别采用手术瘘口修补加组织包埋、纤支镜下生物蛋白胶或支架封堵瘘口及胸腔冲洗引流等保守治疗。结果：12例支气管胸膜瘘中痊愈8例，其中6例手术、2例蛋白胶封堵；4例因呼吸衰竭死亡。结论：肺叶切除术后支气管胸膜瘘，如无脓性胸液，心肺功能良好，应早期积极手术，结合胸腔持续冲洗可获得良好效果，对于支架置入则需谨慎。%Objective:To study the management of postoperative bronchopleural leakage (BPL).Methods:The clinical findings of 12 patients with BPL was retrospectively summarized and analyzed.Results:Of 7 cases underwent re-stapled with costal muscle flap reinforcement.2 cases were sealed off with fibrin sealant and another 2 cases were performed with stent implantation.1 case was conservative treatment.Totally 8 patients recovered completely and 4 ca-ses died due to respiratory failure.Conclusion:Reoperation is still an effective method to treat the post-operative leakage but the implantation stent should be carefully used clinically.