摘要目的探讨外伤性支气管断裂的诊断与治疗。方法回顾性分析1969年6月-1999年6月我院收治的31例外伤性支气管断裂的患者，全部行胸部X线摄片、支气管断层、支气管镜检查。并对其外科治疗和并发症进行探讨。结果通过支气管断层、支气管镜检查全部得到明确诊断。26例施行端端吻合术，4例施行全肺切除术，1例用带血管蒂的肋间肌、肋骨瓣修补破裂成功。1例术后死于呼吸困难综合症，其余30例效果满意。本给81％(25/31)为延迟诊断与治疗。典型临床表现有：皮下气肿、呼吸困难、伤后昏迷间期。X线表现：纵隔气肿、气胸、萎陷肺下垂症、肺的阴影增宽。结论支气管镜是最实用、最准确的诊断与治疗方法。术中使用支气管镜可较容易地找到支气管破裂处。术后肺功能恢复良好。

abstractsObjective To evaluate the diagnosis and management of bronchial rupture from blunt thoracic trauma. Methods A group of 31 patients with bronchial rupture was involved. Chest roentgenography, tornography and bronchoscopy were performed on all patients. The surgical technique and complications were described.Results Diagnosis was confirmed by tomography and bronchoscopy in all the patients. End to end anastomosis was used in 26 patients. Four patients were operated with total pneurnonectomy. One patient was repaired with an intercostal muscle and rib flap with blood supply. Of the 31 patients, one died of adult respiratory distress syndrome after operation. Most patients had excellent surgical outcomes. 81％ (25/31)of the bronchial rupture were delayed in diagnosis and treatment. The classic symptoms and signs of bronchial rupture included subcutaneous emphysema, dyspnea and an intermediate coma interval. The roentgenogram showed mediastinal emphysema, pneumothorax, “drop lung” sign and marked radiodensity of hilum widened mediastinum.Conclusion Bronchoscopy is a useful and accurate method to diagnose and treat the bronchial rupture, with which surgeons can easily locate the rupture site during surgery. Surgical treatment could restore pulmonary function in most patients.