目的

总结支气管胸膜瘘（BPF）患者的临床资料，分析成因，探讨治疗方法及其疗效。

方法

2021年4月至2024年6月大连大学附属中山医院胸外科，共有6例肺切除术后BPF患者，经保守治疗无效后，行支气管镜下治疗（支气管瘘口周围注射聚桂醇）以及外科手术治疗。

结果

6例患者中，男4例，女2例，平均年龄60岁；5例患者接受右肺下叶手术；3例有长期吸烟史；1例伴糖尿病；3例合并贫血和低蛋白血症；支气管残端长度均值（0.8±0.4）cm；术后发生BPF的中位时间71.5天。1例行外科手术修补；5例行内镜下硬化剂注射治疗，其中1例患者R1切除，内镜下治疗失败，转手术修补，介入治疗成功率为80%。随访3～40个月，BPF均愈合。

结论

结合大量相关研究，本组肺切除术后BPF与吸烟、营养不良、右肺下叶手术、R1切除等因素有关，内镜下注射硬化剂治疗效果较好，外科手术仍是终极治疗手段。

Objective

To summarize the clinical data of bronchopleural fistula （BPF） patients，analyze the causes， and explore the treatment methods and efficacy.

Methods

From April 2021 to June 2024 in Department of Thoracic Surgery，Affiliated Zhongshan Hospital of Dalian Uninersity，6 patients with BPF after lung resection were treated with bronchoscopy （injection of polidocanol around the bronchial fistula） and surgical intervention after the failure of conservative treatment.

Results

Among the 6 patients，4 were males and 2 were females，aged 60 years on average；5 patients underwent right lower lobe resection；3 patients had a long history of smoking；1 patient had diabetes mellitus；3 patients had combined anemia and hypoproteinemia.The mean length of the bronchial stump was （0.8±0.4） cm.The median time to postoperative BPF was 71.5 days.One patient underwent thoracoscopic BPF repair.Five patients were treated with endoscopic injection of sclerosing agent，and one of them had R1 resection，failed endoscopic treatment，and was transferred to surgical repair，with a success rate of interventional therapy of 80%.After follow-up of 3 to 40 months，BPF was healed.

Conclusion

Combining a large amount of relevant research，our group found that BPF after lung resection is related to smoking，malnutrition，right lower lobe surgery，and R1 resection.Endoscopic sclerotherapy is effective，yet surgery remains the final treatment.