摘要
目的:总结儿童创伤性支气管断裂的外科诊治经验,探讨其临床处理策略。方法:回顾性分析2014年1月至2017年1月我院收治的8例创伤性支气管断裂患儿的病历资料。本组男5例,女3例,年龄2.5~9.7岁(中位年龄6.5岁),体质量12~30 kg(中位体质量22 kg),右侧支气管断裂2例,左侧6例。结果:8例患儿均在胸部CT或支气管镜检查后明确诊断。本组病例均接受手术治疗,其中7例行支气管端-端吻合术,1例行右肺中叶切除、支气管袖式吻合术。本组无手术死亡,所有患儿治愈出院。门诊随访1~36个月,全组患儿无明显呼吸道症状,影像学检查显示肺膨胀良好,5例患儿随访过程中尚存在轻-中度的支气管狭窄。结论:儿童创伤患者均需警惕支气管断裂的发生,CT和纤维支气管镜检查是儿童创伤性支气管断裂最有价值的诊断方法,儿童创伤性支气管断裂无论早期或延期手术均可取得良好的治疗效果。
Objective：To review the diagnosis and treatment of traumatic bronchial rupture in children and to discuss its appropriate managing strategy. Methods：Medical records of eight children in Children＇s Hospital of Chongqing Medical University from January 2014 and January 2017 were retrospectively analyzed. Eight patients with traumatic bronchial rupture（five boys and three girls）were included,with age from 2.5 to 9.7 years old（median age of 6.5 years old）and weight of 12 to 30 kg（median weight of 22 kg）. Bronchus rupture was diagnosed through imaging studies and bronchoscopy. Among the patients,two had right bronchus rupture,and the other six had left bronchus rupture. Results：Diagnosis of the eight patients was clear after the chest CT with 3-dimensional reconstruction techniques and fibreoptic bronchoscopy. All eight patients received surgery：seven children received end-to-end bronchial anastomosis and one received surgical repair consisted of a sleeve resection（right middle lobectomy with reanastomosis of the bronchus intermedius to the right inferior bronchus）. The results were good. There was no operative death and no postoperative bronchopleural fistula. Five of the eight patients were affected with mild to moderate bronchial stenosis,without apparent respiratory symptom or atelectasis on image analysis after a follow-up up to 36 months. Conclusion：Be alert to bronchial rupture after trauma in children is helpful to the diagnosis. Chest CT with 3-dimensional reconstruction techniques and fiberoptic bronchoscopy are the most valuable diagnostic methods. Results of emergency or delayed surgery in children＇s traumatic bronchial rupture are excellent.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2018年第2期269-273,共5页
Journal of Chongqing Medical University
基金
国家临床重点专科建设资助项目(编号:国卫办医函【2013】544)
关键词
儿童
支气管断裂
创伤/诊断
创伤/治疗
children
chest trauma
bronchial rupture
trauma/diagnosis
trauma/treatment
