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頁籤選單縮合
題名 | Thoracoscopic Retrieval of Foreign Body after Penetrating Chest Injury: Report of Two Cases=以胸腔鏡撙取胸腔穿刺異物:二例報告 |
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作者 | 劉永恆; 劉會平; 林萍章; 張昭雄; Liu, Yun-hen; Liu, Hui-ping; Lin, Pyng Jing; Chang, Chau-hsiung; |
期刊 | 長庚醫學 |
出版日期 | 19990300 |
卷期 | 22:1 1999.03[民88.03] |
頁次 | 頁117-122 |
分類號 | 415.5091 |
語文 | eng |
關鍵詞 | 胸腔鏡; 異物; 穿刺性外傷; Videothoracoscopy; Foreign body; Penetrating trauma; |
中文摘要 | 影像胸腔胸鏡手術已經被證明在許多的胸腔手術中有其價值,而影像胸腔手術在 外傷手術中的利用也快速進展,不論是在胸腔穿刺或鈍性外傷,都可借助影像胸腔鏡來幫忙 。對於胸腔血塊的移除、膿胸的治療、持續漏氣,甚至創傷性乳糜胸,以及橫膈膜裂傷的處 理都是非常安全的選擇。我們現在所報告的兩個個案就是利用胸腔鏡去取出胸腔內的金屬碎 片,而免於胸腔切開術。第一個病人是從上鎖骨凹窩進入右上肺的金屬碎片經由影像胸腔鏡 取出後,肺部則由胸腔鏡直接以傳統性的縫合技術作一修補。而另外一個病人所存在的碎片 則是由下頸部的傷口直接射入左上縱膈腔,也成功地在影像胸腔鏡輔助下取出。兩個病人的 恢復情況良好且順利出院。因此我們覺得,在一個隱定的胸腔穿刺性外傷病人身上,利用胸 腔鏡手術,不僅對診斷有用,且在治療上也有其臨床價值。 |
英文摘要 | Video-assisted thoracic surgery has proved to be valuable in many settings in thoracic surgery. The use of video-assisted thoracic surgery in trauma has recently rapidly increased. It is useful in acute or delayed management of patients with blunt and penetrating chest trauma. It is safe for removal of clotted hemothorax, treatment of thoracic empyema, treatment of persistent pneumothorax, treatment of chylothorax, and for diagnosis of diaphragmatic injury. We report two cases using thoracoscopy to remove intrathoracic metal fragments and avert the need for thoracotomy. In the first patient, a metal fragment injury was sustained via a penetrating wound from the supraclavicular notch to the right upper lung. The metal fragment was retrieved and the lung was repaired thoracoscopically using conventional suturing techniques. A second patient sustained a broken pin injury to the left upper mediastinum via a low neck wound. The pin was successfully removed under videothoracoscopy. Both patients recovered uneventfully and had shortened hospital stays. We feel that thoracoscopy offers a therapeutic as well as diagnostic benefit in stable patients with penetrating chest trauma. |
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