目的：总结钝性支气管损伤诊断和治疗经验。方法2002年1月至2009年12月收治钝性支气管损伤患者18例。均经纤维支气管镜明确诊断，其中，主支气管损伤12例，叶支气管损伤6例。均采用外科手术治疗，其中，急诊手术15例，择期手术3例。手术方法包括支气管端端吻合术15例，裂伤修补术3例。结果本组无死亡病例。1例急诊行支气管裂伤修补术，术后3 d修补处缺血坏死，切除坏死组织后行支气管端端吻合术。13例术后愈合良好，基本恢复正常活动。5例术后出现吻合口狭窄，4例纤维支气管镜下切除及液氮冷冻肉芽组织后缓解，1例疗效不佳，因反复狭窄及严重呼吸困难，术后6个月行肺叶切除术。结论纤维支气管镜检查能迅速明确诊断，早期外科手术是提高成功救治率的关键。%Objective To sum up the experience on diagnosis and treatment of blunt bronchial injuries .Methods From January 2002 to December 2009 ,18 patients with blunt broncheal injuries were admitted .The definitive diagnosis was confirmed by fibro-bronchoscopy .Twelve patients suffered from main bronchial injuries and the remaining 6 patients from lobe bronchial injuries .All patients managed with surgical therapies .Emergent operation was performed in 15 patients and elective operation in 3 patients .End to end bronchial anastomosis was performed in 15 patients and primary repair in 3 patients .Results There was no death in this group .One patient after emergent primary repair developed ischic necrosis in the repair site on 3 the postoperative day and under-went resection of the necrotic tissue followed by end to end anastomsis .Thirteen patients had no complications and were able to take part in normal activities .Anastomotic stricture occurred in 5 patients and managed with granulation tissue resection and cryothera-py .Four patients were healed but one patient underwent lobectomy 6 months later as a result of recurrent stricture and severe dysp-nea .Conclusion Fibrobronchoscopy is able to define the blunt bronchial injuries immediately .Early surgery after trauma can im-prove the successful rate of treatment .
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