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題名 | Surigcal Management of Bronchiectasis=支氣管擴張症的外科治療 |
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作 者 | 林進德; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 21:3 1988.05[民77.05] |
頁次 | 頁318-325 |
分類號 | 416.224 |
關鍵詞 | 支氣管擴張症; 外科治療; |
語文 | 英文(English) |
中文摘要 | 從1966年一月至1986年十二月,於本院接受外科治療而有詳細追踪資料之支氣管擴張症病人有120位,年齡由13到61歲平均43歲,男與女為83比37。其主要症狀為大量咳痠(68.5%),咳血(68.5%),胸痛及發燒,約有三分之二病人有經常性呼吸道感染的過去史,最常侵犯的部位為左下肺葉(32.5%),我們手術適應症為:內科治療失敗,大量咳血、合併有胸腔內的併發症(如膿胸),及懷疑是惡性病灶。總共實行120個手術:69例肺葉切除術,14例雙肺葉切除術,14例肺葉切除加肺節切除術,6例肺節切除術,14例全肺切除術(13例左側、1例右側),平均手術切除4.3個肺節,手術死亡有3例、6例合併膿胸其中3例轉變成支氣肋膜瘻管、手術併發比率為16%平均追踪有3.3年(4個月至18年),51%的病人手術後,再無症狀,另外30%有明顯進步,10%有少許進步,8%持續有症狀或結果不好。 |
英文摘要 | From January 1966 to December 1986, one hundred twenty patients with bronchiectasis have been operated on at this hospital, with adequate follow-up for all. Patient's age ranged from 13 to 61 with a mean of 43 years. There were 83 males and 37 females.The leading presenting symptoms and signs were productive cough (68.5%) and hemoptysis (68.5%), with the most common lesion site over the left lower lobe (32.5%). All the operations were performed after the indications of failure of medical treatment, uncontrolled hemoptysis, combination with intrathoracic complications or for suspected malignancy. The procedures included 69 lobectomies, 14 bilobectomies, 14 lobectomies with segmenta1 resections, 6 segmental resections, 3 decortications and 14 pneumonectomies. There were three operative mortalities. Postoperative empyema developed in six patients (5%), of whom half then changed into bronchopleural fistula. The total operative complication rate was 16.6%. Follow-up was from 4 months to 18 years with an average of 3.3 years. The results showed symptom-free in 61 cases (51%), much improved in 36 cases (30%), slightly improved in 13 cases (11%) and poor in 10 cases (8%). |
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