两种支气管残端处理方式对肺癌切除术后并发支气管胸膜瘘的比较.docVIP

18990342335 daixiaohui126@163.com 两种支气管残端处理方式对肺癌切除术后并发支气管胸膜瘘的影响 代晓辉 四川省仁寿县人民医院胸外科，620500. 【摘要】 目的 比较间断全层缝合法(Sweet法)与支气管闭合器闭合法对肺癌切除术后支气管胸膜瘘发生的影响。方法 选取2010年3月至2012年5月间本院胸外科收治的120例非小细胞肺癌患者，均行解剖性肺叶切除手术+系统性肺门纵隔淋巴结清扫术，根据支气管残端处理方式的不同分为两组：Sweet法组(n=60)切除时采用间断全层缝合法闭合支气管残端，闭合器组(n=60)采用支气管闭合器处理支气管残端，比较两组病例支气管闭合时间及术后支气管胸膜瘘的发生情况。结果 闭合器组支气管闭合时间为(10.55±7.14)分钟，短于Sweet法组闭合时间(31.66±8.76)分钟，差异有统计学意义(p＜0.05)。随访6月，120例肺切除患者不同支气管残端处理后共发生2例支气管胸膜瘘，支气管胸膜瘘总发生率为1.67%：其中Sweet法组术后发生支气管胸膜瘘1例，支气管胸膜瘘发生率1.67%，闭合器组术后发生支气管胸膜瘘1例，支气管胸膜瘘发生率1.67%，两组支气管胸膜瘘发生率无显著差异(p＞0.05)。结论 间断全层缝合法(Sweet法)和支气管闭合器闭合法在处理肺癌切除术支气管残端时，支气管胸膜瘘的发生情况基本相同，但支气管闭合器闭合支气管速度快、易于掌握，临床上需根据具体病情，结合患者自身经济条件进行选择。 【关键词】 肺癌 肺切除术 支气管胸膜瘘 支气管闭合方法 The effect of two bronchi-closing methods on incidence of bronchopleural fistula after lobectomy for non-small cell lung cancer [Abstract] Objective To compare the effect of two bronchi-closing methods on incidence of bronchopleural fistula after lobectomy for non-small cell lung cancer. Methods Lobectomy was performed in patients with non-small cell lung cancer from March 2010 to May 2012 in our hospital. Two methods of bronchi-closing were applied: (1) bronchi-closing device, (2) simple full-thickness interrupted suture(Sweet method). The bronchi-closing time, incidence of bronchopleural fistula were observed and compared between the two groups. Results The bronchi-closing time in bronchi-closing device group and Sweet suture group were (10.55±7.14)min, (31.66±8.76) min respectively, with significant statistical difference(p＜0.05). Bronchopleural fistula occurred in 1 case in bronchi-closing device group and 1 case in Sweet suture group. Incidence of bronchopleural fistula was 1.67%, 1.67% respectively, without significant statistical difference between the two group(p＞0.05). Conclusion Compared to Sweet method, bronchi-closing device didn’t reduce occurrence of bronchopleural fistula, but shortened bronchi-closing time. Choice is depending on disease and patients’ economic conditions. [Key word