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題 名 | Surgical Treatment of Bronchiectasis=支氣管擴張症之外科治療 |
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作 者 | 吳明和; 林木源; 曾堯麟; 賴吾為; | 書刊名 | 中華民國外科醫學會雜誌 |
卷 期 | 29:2 民85.03-04 |
頁 次 | 頁145-151 |
分類號 | 416.224 |
關鍵詞 | 支氣管擴張症; 外科治療; Pulmonary resection; Bronchiectasis; |
語 文 | 英文(English) |
中文摘要 | 在七年之間本院有三十六位患有非結核性支氣管擴張症的病人接受肺 切除手術。所有這些病人都有嚴重的臨床症狀,經過內科治療無效後,才轉至外 科做手術。最主要的手術適應症是慢性咳血(80%)並有咳嗽及膿痰。其中三十一 位病人之支氣管擴張症,侷限於一例肺部僅執行單側之疾病肺之切除,其他五位 病人之病灶分散於兩側肺部因而執行兩側之肺切除手術。在所有病人申,有兩位 病人切除十個以上之肺節,九位病人做肺全切除術,肺全切術以左側為多。全部 手術無死亡率,但是有五例病人有嚴重手術合併症;包括三例膿胸,二例支氣管 肋膜腔�硎�;膿胸綴以肋膜腔空針抽吸,而支氣管肋膜腔�硎瑏g以支氣管縫合及 胸廓成型術,全部手術合併症經妥當治療後病人皆痊癒。在所有病人中十六例有 手術前及手術後的肺功能檢查資料,這些資料分析顯示手術後的肺功能並沒有顯 著的改變。所有手術的病人於手術後症狀獲得緩解,兩例切除十個肺節以上的病 人其感染症狀及虛弱之情況已獲得解除,也因此重回工作崗位。對於患有支氣管 擴張症的病人做適當的選擇,肺切除可以使得他們的症狀改善,獲得實際的益處。 |
英文摘要 | Thirty-six patients with non-tuberculous bronchiectasis underwent pulmonary resection in our hospital from July 1988 to June 1995. All patientssuffered from significant symptoms that did not respond to medical treatment, and repeated hemoptysis (80) associated with cough and productivepurulent sputum was the leading indication for operation. Thirty one patients with unilateral bronchiectatic lesions required resection of diseasedlung tissue, and the remaining 5 patients with bilateral lesions requiredsimultaneous bilateral pulmonary resections. Among all patients, two (6)underwent resection of more than 10 lung segments and 9 (25) underwentpneumonectomy with left predominated. There was no operative death, but5 patients (13.5) had significant complications consisting of empyema (n=3) and bronchopleural fistula (n= 2). The empyema in all these 3 patientswas treated by thoracocentesis, and the bronchopleural fistula in bothpatients by bronchial closure and thoracoplasty. All the operative complications were properly treated, and these patients completely recovered.Sixteen patients had available preoperative and postoperative pulmonaryfunction did not have significant changes as compared with the preoperative one. All the patients finally achieved relief of symptoms. Two patientswho underwent resection of more than 10 lung segments had been freefrom infection and disability, and returned to work. It is concluded that inproperly selected bronchiectatic patients, complete resection of diseasedlung tissues can provide a definite benefit for their symptomatic improvement. |
本系統中英文摘要資訊取自各篇刊載內容。