带蒂前锯肌瓣修补肺癌术后支气管残端瘘体会.docVIP

带蒂前锯肌瓣修补肺癌术后支气管残端瘘体会作者单位：525000 广东省茂名市人民医院 通讯作者：黄健宏 【摘要】 目的 观察带蒂前锯肌瓣修补肺癌切除术后支气管残端瘘的疗效。方法 回顾性分析本院1992年6月～2009年6月612例因肺癌接受全肺切除术患者中24例术后支气管残端瘘患者的临床资料，其中11例患者接受带蒂前锯肌瓣修补术，13例患者应用生物胶封堵，对不同手术方法的治愈率进行比较分析。结果 接受带蒂前锯肌瓣修补术的11例患者中10例治愈出院，治愈率为90.9%；接受生物胶封堵术的13例患者中9例治愈出院，治愈率为69.2%。结论 带蒂前锯肌瓣用于修补肺癌术后支气管残端瘘，具有操作简便和治愈率高的特点。 【关键词】 带蒂前锯肌瓣； 支气管残端瘘； 肺癌全切术 Experiences on treating postpneumonectomy bronchopleural fistula with anterior muscle flap neoplasty HUANG Jian-hong，WANG Mao-sheng,HUANG Jian.Maoming People’s Hospital, Maoming 525000,China 【Abstract】 Objective To observe the curative effect of serratus anterior muscle flap neoplasty in the treatment of bronchopleural fistula after pulmonary resections for lung cancer.Methods Reviewed the clinical data of 24 cases of postpneumonectomy bronchopleural fistula out of 612 patients who received total pneumonectomy for lung cancer in our hospital between June 1992 and June 2009. 11 cases were treated with serratus anterior muscle flap neoplasty while 13 cases were treated with biologic glues applied brounchoscopically to close the fistula. The cure rate of the two groups treated with different methods was compared.Results Of the 11 cases treated with serratus anterior muscle flap neoplasty, 10 were cured with a cure rate of 90.9%, and of the 13 cases treated with biologic glues, 9 were cured with a cure rate of 69.2%. There was no statistical difference between the two groups （P0.05）.Conclusion Serratus anterior muscle flap neoplasty, which is charactered by easy operation and high cure rate, is of great clinical importance. 【Key words】 Serratus anterior muscle flap; Lung cancer; Bronchopleural fistula 支气管残端瘘（bronchopleural fistula, BPF）是肺癌全肺切除术后最为严重的术后并发症之一，指支气管与胸膜间形成的异常通道，可因术后感染等原因形成。其病理机制是慢性脓胸的脓液腐蚀周围肺组织后穿破支气管，也可因肺内病灶破溃至胸膜腔或直接侵袭胸腔形成瘘管，切除脓腔感染或胸腔穿刺也可造成残端瘘。脓液可从支气管咳出形成脓性痰，严重时大量脓液吸入支气管，令患者窒息而死。肺癌术后BPF的病死率很高，对患者的生命造成了很大威胁［1］。为妥善处理肺癌术后BPF，选择一种操作简便、安全有效的手术方法十分必要。本次研究回顾性分析本院1992年6月～2009年6月612例因肺癌接受全肺切除术患者中24例术后BPF患者的临床资料，对不同手术方