• 遼寧省腫瘤醫(yī)院 胸外科,沈陽 110042;

目的 分析經(jīng)纖維支氣管鏡注入100%石碳酸溶液治療支氣管胸膜瘺的療效?!》椒ā』仡櫺苑治鲞|寧省腫瘤醫(yī)院2009年2月至2012年3月術(shù)后并發(fā)支氣管胸膜瘺患者12例的臨床資料,其中男11例,女1例;年齡58.0 (45~71)歲;全組患者均為原發(fā)性肺癌,其中鱗癌8例,腺癌4例;中心型肺癌8例,周圍型肺癌4例;3例行右全肺切除術(shù),6例行左全肺切除術(shù),2例行右肺中下葉切除術(shù),1例行左肺上葉切除術(shù)?;颊呓?jīng)纖維支氣管鏡滴注100%石碳酸溶液,每次0.5~1.0 ml滴至支氣管胸膜瘺黏膜處,觀察胸腔閉式引流管氣體溢出情況,若1周后仍有氣體溢出可反復(fù)注射。分析其療效。 結(jié)果 12例患者有8例經(jīng)5次石碳酸滴注后瘺口閉合,2例經(jīng)過7次,2例經(jīng)過2次治療后瘺口閉合。瘺口平均閉合時間33 d,除2例患者因體弱分別住院42 d和50 d外,其余患者均于門診治療痊愈,總有效率100%?!〗Y(jié)論 經(jīng)纖維支氣管鏡瘺口內(nèi)滴注100%石碳酸溶液治療支氣管胸膜瘺療效確切。

引用本文: 王征,玉寒冰,羅全. 石碳酸經(jīng)纖維支氣管鏡滴注治療支氣管胸膜瘺. 中國胸心血管外科臨床雜志, 2013, 20(1): 78-80. doi: 復(fù)制

1.  Chawla RK, Madan A, Bhardwaj PK, et al. Bronchoscopic  management of bronchopleural fistula with intrabronchial instillation of glue (N-butyl cyanoacrylate) . Lung India, 2012, 29 (1):11-14.
2.  Takaoka K, Inoue S, Ohira S. Central bronchopleural fistulas closed by bronchoscopic injection of absolute ethanol. Chest, 2002, 122 (1):374-378.
3.  Mathisen DJ, Grillo HC, Vlahakes GJ, et al. The omentum in the management of complicated cardiothoracic problems. J Thorac  Cardiovasc Surg, 1988, 95 (4):677-684.
4.  Jessen C. Sharma P. Use of fibrin glue in thoracic surgery. Ann Thorac Surg, 1985, 39 (6):521-524.
5.  Roukema JA, Verpalen MC, Lobach HJ, et al. Bronchopleural fistula:the use of tissue glue. J Thorac Cardiovasc Surg, 1992, 103 (1):167.
6.  Mcmanigle JE, Fletcher GL, Tenholder MF. Bronchoscopy in the management of bronchopleural fistula. Chest, 1990, 97 (5):1235-1238.
7.  Cerfolio RJ. The incidence, Etiology and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg, 2001, 13 (1):3-7.
8.  Sirbu H, Busch T, Aleksic I, et al. Bronchopleural fistula in the surgery of non-small cell lung cancer:incidence, risk factors, and management. Ann Thorac Cardiovasc Surg, 2001, 7 (6):330-336.
9.  Turk AE, Karanas YL, Cannon W, et al. Staged closure of complicated bronchopleural fistulas. Ann Plast Surg, 2000, 45 (5):560-564.
10.  Hollaus PH, Lax F, el-Nashef BB, et al. Natural history of bronchopleural fistula after pneumonectomy:a review of 96 cases. Ann Thorac Surg, 1997, 63 (5):1391-1396.
11.  Panagopoulos ND, Apostolakis E, Koletsis E, et al. Low incidence of bronchopleural fistula after pneumonectomy for lung cancer. Interact Cardiovasc Thorac Surg, 2009, 9 (4):571-575.
12.  Nemati A, Safavi E, Ghasemiesfe M, et al. Fistula formation between the right and left main bronchus caused by endobronchial tuberculosis. Am J Med Sci, 2012, 343 (4):330-331.
13.  Pu LL. Successful management of a recalcitrant bronchopleural fistula associated with infection after total pneumonectomy. J Plast Reconstr Aesthet Surg, 2010, 63 (2):e180-e182.
14.  Finch CK, Pittman AL. Use of fibrin glue to treat a persistent pneumothorax with bronchopleural fistula. Am J Health Syst Pharm, 2008, 65 (4):322-324.
15.  Uçvet A, Gursoy S, Sirzai S, et al. Bronchial closure methods and risks for bronchopleural fistula in pulmonary resections:how a surgeon may choose the optimum method? Interact Cardiovasc Thorac Surg, 2011, 12 (4):558-562.
16.  Davis RA, Hofmann A, Osman A, et al. Natural product-based phenols as novel probes for mycobacterial and fungal carbonic anhydrases. J Med Chem, 2011, 54 (6):1682-1692.
17.  Kim DW, Ahn DS. Delayed wound healing and scarring after combined ablative laser and phenol peel treatment. J Plast Reconstr Aesthet Surg, 2010, 63 (5):e484-e485.
18.  Sonobe M, Nakagawa M, Ichinose M, et al. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung Cancer. Eur J Cardiothorac Surg, 2000, 18 (5):519-523.
19.  王志軍. 石碳酸在直腸陰道瘺治療中的應(yīng)用. 中外醫(yī)學(xué)研究,2009, 7 (9):65-66..
  1. 1.  Chawla RK, Madan A, Bhardwaj PK, et al. Bronchoscopic  management of bronchopleural fistula with intrabronchial instillation of glue (N-butyl cyanoacrylate) . Lung India, 2012, 29 (1):11-14.
  2. 2.  Takaoka K, Inoue S, Ohira S. Central bronchopleural fistulas closed by bronchoscopic injection of absolute ethanol. Chest, 2002, 122 (1):374-378.
  3. 3.  Mathisen DJ, Grillo HC, Vlahakes GJ, et al. The omentum in the management of complicated cardiothoracic problems. J Thorac  Cardiovasc Surg, 1988, 95 (4):677-684.
  4. 4.  Jessen C. Sharma P. Use of fibrin glue in thoracic surgery. Ann Thorac Surg, 1985, 39 (6):521-524.
  5. 5.  Roukema JA, Verpalen MC, Lobach HJ, et al. Bronchopleural fistula:the use of tissue glue. J Thorac Cardiovasc Surg, 1992, 103 (1):167.
  6. 6.  Mcmanigle JE, Fletcher GL, Tenholder MF. Bronchoscopy in the management of bronchopleural fistula. Chest, 1990, 97 (5):1235-1238.
  7. 7.  Cerfolio RJ. The incidence, Etiology and prevention of postresectional bronchopleural fistula. Semin Thorac Cardiovasc Surg, 2001, 13 (1):3-7.
  8. 8.  Sirbu H, Busch T, Aleksic I, et al. Bronchopleural fistula in the surgery of non-small cell lung cancer:incidence, risk factors, and management. Ann Thorac Cardiovasc Surg, 2001, 7 (6):330-336.
  9. 9.  Turk AE, Karanas YL, Cannon W, et al. Staged closure of complicated bronchopleural fistulas. Ann Plast Surg, 2000, 45 (5):560-564.
  10. 10.  Hollaus PH, Lax F, el-Nashef BB, et al. Natural history of bronchopleural fistula after pneumonectomy:a review of 96 cases. Ann Thorac Surg, 1997, 63 (5):1391-1396.
  11. 11.  Panagopoulos ND, Apostolakis E, Koletsis E, et al. Low incidence of bronchopleural fistula after pneumonectomy for lung cancer. Interact Cardiovasc Thorac Surg, 2009, 9 (4):571-575.
  12. 12.  Nemati A, Safavi E, Ghasemiesfe M, et al. Fistula formation between the right and left main bronchus caused by endobronchial tuberculosis. Am J Med Sci, 2012, 343 (4):330-331.
  13. 13.  Pu LL. Successful management of a recalcitrant bronchopleural fistula associated with infection after total pneumonectomy. J Plast Reconstr Aesthet Surg, 2010, 63 (2):e180-e182.
  14. 14.  Finch CK, Pittman AL. Use of fibrin glue to treat a persistent pneumothorax with bronchopleural fistula. Am J Health Syst Pharm, 2008, 65 (4):322-324.
  15. 15.  Uçvet A, Gursoy S, Sirzai S, et al. Bronchial closure methods and risks for bronchopleural fistula in pulmonary resections:how a surgeon may choose the optimum method? Interact Cardiovasc Thorac Surg, 2011, 12 (4):558-562.
  16. 16.  Davis RA, Hofmann A, Osman A, et al. Natural product-based phenols as novel probes for mycobacterial and fungal carbonic anhydrases. J Med Chem, 2011, 54 (6):1682-1692.
  17. 17.  Kim DW, Ahn DS. Delayed wound healing and scarring after combined ablative laser and phenol peel treatment. J Plast Reconstr Aesthet Surg, 2010, 63 (5):e484-e485.
  18. 18.  Sonobe M, Nakagawa M, Ichinose M, et al. Analysis of risk factors in bronchopleural fistula after pulmonary resection for primary lung Cancer. Eur J Cardiothorac Surg, 2000, 18 (5):519-523.
  19. 19.  王志軍. 石碳酸在直腸陰道瘺治療中的應(yīng)用. 中外醫(yī)學(xué)研究,2009, 7 (9):65-66..