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find Author "刘兴元" 2 results
  • 带蒂肋间肌瓣防治支气管胸膜瘘17例临床分析

    目的 探讨采用带蒂肋间肌瓣包埋支气管残端预防和治疗支气管胸膜瘘的临床意义,总结治疗经验。 方法  回顾性分析2001年10月至2009年6月重庆市江津中心医院对17例肺癌、肺结核伴支气管扩张、支气管扩张患者行肺切除术后采用带蒂肋间肌瓣包埋支气管残端的临床资料。14例为预防性治疗,男8例,女6例;年龄21~69岁;其中6例行全肺切除术,8例行肺叶切除术。3例行肺癌肺叶切除术后支气管胸膜瘘二期修补术,男2例,女1例;年龄58~68岁。 结果 预防性治疗14例患者,手术时间135~275 min,均治愈,无并发症;随访12例,随访时间6~60个月,随访期间无1例发生支气管胸膜瘘。3例肺癌术后支气管胸膜瘘接受带蒂肋间肌瓣治疗患者手术时间75~165 min,2例痊愈,1例同时行局部胸膜内胸廓成形术痊愈;3例均随访6~24个月,无1例再发支气管胸膜瘘。 结论  带蒂肋间肌瓣包埋支气管残端防治支气管胸膜瘘安全有效,尤其适用于肺切除术后支气管残端或吻合口的加固预防支气管胸膜瘘的发生。

    Release date:2016-08-30 05:56 Export PDF Favorites Scan
  • Variation of right B2 downwards-shift: A special type of tracheal bronchus

    Background To analyze and summarize the changes of the bronchus and vessels of right B2 downwards-shift. Methods Patients who underwent three-dimensional computed tomography bronchography and angiography (3D-CTBA)Between January 2019 and January 2022 were screened. Based on the opening position of B1+3, we classified bronchial variations into normal type, over type, and tracheal-bronchus type. Results Initially 5 280 patients were screened, and finally 6 patients were included, including 1 male and 5 females, aged 29 to 71 years. According to our bronchial classification, there were 4 (66.7%) patients of the normal type in this group, 1 (16.7%) patient was the over type;1 patient (16.7%) was the tracheal-bronchus type.In artery, 4 (66.7%) patients was the Tr.sup+A.post type and 2 (33.3%) patients was the Tr.sup+Tr.inf+A.post type have. In vein, 2 (33.3%) patients was the Ⅰab+UVPBI type, 1 (16.7%) patient the Ⅰb+UVPBI type, 1 (16.7%) patient the Anterior+UVPBI type have, 1 (16.7%) patient the Central+UVPBI type and 1 (16.7%) patient the Central type. Conclusion There is a variation combination in the right B2 downwards-shift: the right B2 downwards-shift, exist posterior artery(A.post), the posterior oblique fissure is poorly developed(RS2 and RS6 are interconnected).Therefore, it is easier for us to dissect and disconnect B2 intraoperative, but it is necessary to be vigilant for vascular damage caused by opening the posterior oblique fissure.

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