创伤性主支气管断裂的诊治论文

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1、创伤性主支气管断裂的诊治论文.freelentfortraumaticmainbronchialrupture.MethodsChestXrays，CTandfiberopticbronchoscopyainmeanstoconfirmthediagnosis.Bronchialendtoendanastomosisedin10patientsandpneumonectomyononecasebecauseofinfection.ResultsAllthelungsentAcuteinjuriesofbronchialsystemarerareandlifet

2、hreateningsituations，blunt/peratingchestandhasdifferentclinicalpictures［3～6］，occurrencesoftheseinjuriesareonlyabout0.8%ofallchestinjuries.Since1994，entforthesecasesarereportedhere.1Clinicalinformation1.1GeneralinformationTheinformation1994to2003atourhospitals.Thegroupconsistedof11patient

3、s(male：7cases，female：4cases)ergencydepartment(seeFig.1，2).Allinjuriesinvolvedthemainstembronchi.Therightmainbronchialruptureconsistedof4cases，ainbronchial7cases.Theshortesttimeoftraumaeostmonpresentingsignsofairothorax，mediastinumandsubcutaneousemphysemain8cases，hemoptysisin5cases.In7pat

4、ientstheatelectasisonthsaftertrauma.Radiology：chestXrayshoainbronchusmightresultintheclassicsignsofatelectasis，“absenthilum”oracollapsingofthelungathehilusto，knope.CTshoaydirectlyrevealbronchialruptureorstenosis.Fiberopticbrochoscopy：thebronchialcutoffin4patientsaandthedistancebetentBro

5、nchialruptureosisin10patientsofthisgroup(seeTable1).Afteroperation，thelobesedduetopulmonaryinfection.Allthepatientsprovedobviously.Table1Patients’lesionsitesandsurgicaltreatment2Discussion2.1DiagnosisTheclinicalfindingsformostpatientsaticmainbronchialruptureareplicatedbecausetheirclinica

6、lsymptomscanbelessenedthroughcloseddrainagesothatisforustotimelymakeanearlierdiagnosisforthem.Becauseofthis，theonethirdofpatientscanbesavedbytimelymakingdiagnosisandcorrecttreatment.Thediagnosisforthebronchialruptureisbaseduponclinical，radiological，andendoscopicalfinding.Theclinicalpres

7、entationsforthebronchialruptureintheearliertraumaticstageconstitute2types.TypeⅠ：bronchialcrackisconnectedtopleuralcavity，aticpneumothorax.6patientsoutofthisgroupbelongedtothistype.TypeⅡ：bronchialcrackiscoveredediastinalpleuralsoasnottodirectlybegottenthroughthepleuralcavi