XU Tongyi,WANG Yun,FAN Shaowei,et al.Experience and literature review in emergency video-assisted thoracoscopic surgery for projectile injuries in the lung caused by stray bullet explosion[J].J Third Mil Med Univ,2021,43(17):1703-1706.

流弹爆炸致肺破片伤急诊胸腔镜手术救治体会并文献复习(/HTML )




Experience and literature review in emergency video-assisted thoracoscopic surgery for projectile injuries in the lung caused by stray bullet explosion
XU Tongyi WANG Yun FAN Shaowei LI Hao LI Tao

Department of Cardiovascular and Thoracic Surgery, No. 971 Hospital of PLA Navy, Qingdao, Shandong Province, 266071, China

R443.8; R655.3; R826.2
[关键词] 爆炸肺破片伤;胸腔镜;急诊手术 

ObjectiveTo investigate the application of video-assisted thoracoscopic (VATS) surgery in emergency treatment of projectile injuries in the lung caused by explosion. MethodsA case of projectile injury shot in the left lower lung by a stray bullet was admitted in our department in December 2020. After three-dimensional reconstruction of lung CT images, echocardioghaphy and other preoperative evaluations, emergency VATS wedge resection of the right inferior lobe, right hemothorax removal and right chest wall wound enlargement surgery were performed. ResultsThe patient was successfully rescued and discharged from our hospital after surgery, and no significant complication was observed at 2 months after follow-up. The hematoma and inflammation along the projectile in the lung were obviously absorbed. ConclusionThe VATS surgery can be used in the emergency treatment of projectile injuries in the lung caused by explosion, and provides support for the minimally invasive emergency treatment of war wounds of the chest.


[1]GALANTE J, LONDON J A. Left ventricular bullet embolus: a case report and review of the literature[J]. J Emerg Med, 2010, 39(1): 25-31. DOI:10.1016/j.jemermed.2007.09.057.
[2]POON H, MORRISON J J, APODACA A N, et al. The UK military experience of thoracic injury in the wars in Iraq and Afghanistan[J]. Injury, 2013, 44(9): 1165-1170. DOI:10.1016/j.injury.2013.01.041.
[3]张连阳, 李阳. 爆炸伤的院前急救与早期救治策略[J]. 第三军医大学学报, 2020, 42(18): 1771-1776. DOI:10.16016/j.1000-5404.202006240.
ZHANG L Y, LI Y. Strategies for pre-hospital and early in-hospital management for explosion injuries[J]. J Third Mil Med Univ, 2020, 42(18): 1771-1776. DOI:10.16016/j.1000-5404.202006240.
[4]MATHEWS Z R, KOYFMAN A. Blast injuries[J]. J Emerg Med, 2015, 49(4): 573-587.
[5]WILKERSON G R, LEMON C, FALCONE R E. Blast injuries[J].Trauma Rep,2016,17( 3): 1-19.
[6]BALLIVET DE RGLOIX S, CRAMBERT A, MAURIN O, et al. Blast injury of the ear by massive explosion: a review of 41 cases[J]. J R Army Med Corps, 2017, 163(5): 333-338. DOI:10.1136/jramc-2016-000733.
[7]MIYAWAKI H, SAITOH D, HAGISAWA K, et al. Noradrenalin effectively rescues mice from blast lung injury caused by laser-induced shock waves[J]. Intens Care Med Exp, 2015, 3(1): 32. DOI:10.1186/s40635-015-0069-7.
[8]HUANG J Z, YANG Z, WANG Z, et al. Study on characteristics of blast-fragment combined injury in dogs[J]. J Trauma, 1996, 40(3 Suppl): S63-S67. DOI:10.1097/00005373-199603001-00014.
[9]杨策, 蒋建新, 王正国, 等. 肺冲击伤转化研究: 历史、现状与挑战[J]. 实用医药杂志, 2019, 36(1): 1-5,8. 
YANG C, JIANG J X, WANG Z G, et al. Transformation research of pulmonary blast injury: history, current situation and challenges[J]. Pract J Med Pharm, 2019, 36(1): 1-5,8.
[10]邵飞, 杨志鹏. 单发子弹致多处肢体创伤1例[J]. 创伤外科杂志, 2018, 20(4): 316-317. 
SHAO F, YANG Z P. Treatment of multiple limb trauma and fracture caused by single bullet in 1 case[J]. J Trauma Surg, 2018, 20(4): 316-317.
[11]陈秀, 邵伟庆, 赵红, 等. 火器致胸部穿透伤1例救治分析[J]. 创伤外科杂志, 2013, 15(1): 96. 
CHEN X, SHAO W Q, ZHAO H, et al. Treatment of transmediastinal gunshot wound in 1 case[J]. J Trauma Surg, 2013, 15(1): 96.
封[12]张珺, 李海波, 梁宇, 等. 火器伤急诊腹腔镜探查1例并文献复习[J]. 中国微创外科杂志, 2017, 17(4): 379-380. 
ZHANG J, LI H B, LIANG Y, et al. Emergency laparoscopic exploration for firearm injury: case report and review of literature[J]. Chin J Minim Invas Surg, 2017, 17(4): 379-380.
[13]IGOR KHOMENKO, IEVGEN TSEMA, PAVLO SHKLYAREVYCH. Pulmonary artery embolism by a metal fragment after a booby trap explosion in a combat patient injured in the armed conflict in East Ukraine: a case report and review of the literature[J]. J Med Case Rep, 2018, 12(1): 330. 
[14]FACKLER M L, BRETEAU J P, COURBIL L J, et al. Open wound drainage versus wound excision in treating the modern assault rifle wound[J]. Surgery, 1989, 105(5): 576-584. 
[15]许川, 李兵仓. 爆炸破片伤的机制、特点及早期外科处理[J]. 创伤外科杂志, 2011, 13(1): 86-89. 
XU C, LI B C. The mechanism, characteristics and primary surgery treatment for explosive injuries[J]. J Trauma Surg, 2011, 13(1): 86-89.
[38]KO J M, NING L, ZHAO X K, et al. BRCA2 loss-of-function germline mutations are associated with esophageal squamous cell carcinoma risk in Chinese[J]. Int J Cancer, 2020, 146(4): 1042-1051. DOI:10.1002/ijc.32619.
[39]MATEO J, CARREIRA S, SANDHU S, et al. DNA-repair defects and olaparib in metastatic prostate cancer[J]. N Engl J Med, 2015, 373(18): 1697-1708. DOI:10.1056/NEJMoa1506859.
[40]MATEO J, PORTA N, BIANCHINI D, et al. Olaparib in patients with metastatic castration-resistant prostate cancer with DNA repair gene aberrations (TOPARP-B): a multicentre, open-label, randomised, phase 2 trial[J]. Lancet Oncol, 2020, 21(1): 162-174. DOI:10.1016/S1470-2045(19)30684-9.
[41]CAMPOS-CARRILLO A, WEITZEL J N, SAHOO P, et al. Circulating tumor DNA as an early cancer detection tool[J]. Pharmacol Ther, 2020, 207: 107458. DOI:10.1016/j.pharmthera.2019.107458.
[42]OELLERICH M, SCHTZ E, BECK J, et al. Using circulating cell-free DNA to monitor personalized cancer therapy[J]. Crit Rev Clin Lab Sci, 2017, 54(3): 205-218. DOI:10.1080/10408363.2017.1299683.
[43]NAKAMURA Y, YOSHINO T. Clinical utility of analyzing circulating tumor DNA in patients with metastatic colorectal cancer[J]. Oncologist, 2018, 23(11): 1310-1318. DOI:10.1634/theoncologist.2017-0621.
[44]WYATT A W, ANNALA M, AGGARWAL R, et al. Concordance of circulating tumor DNA and matched metastatic tissue biopsy in prostate cancer[J]. J Natl Cancer Inst, 2017, 109(12): djx118. DOI:10.1093/jnci/djx118.
[45]GOODALL J, MATEO J, YUAN W, et al. Circulating cell-free DNA to guide prostate cancer treatment with PARP inhibition[J]. Cancer Discov, 2017, 7(9): 1006-1017. DOI:10.1158/2159-8290.CD-17-0261.
[46]VOLANTE M, TOTA D, GIORCELLI J, et al. Androgen deprivation modulates gene expression profile along prostate cancer progression[J]. Hum Pathol, 2016, 56: 81-88. DOI:10.1016/j.humpath.2016.06.004.
[47]HORNING A M, WANG Y, LIN C K, et al. Single-cell RNA-seq reveals a subpopulation of prostate cancer cells with enhanced cell-cycle-related transcription and attenuated androgen response[J]. Cancer Res, 2018, 78(4): 853-864. DOI:10.1158/0008-5472.CAN-17-1924. 


 YANG Xin-hua,JIANG Jun,FAN Lin-jun,et al.Thoracoscopic internal mammary nodes dissection for breast cancer[J].J Third Mil Med Univ,2007,29(17):1719.
 Zhang Yan,Huang Jiehui,Zhao Xinguo.Thoracoscopic appearance of senile tuberculous pleurisy[J].J Third Mil Med Univ,2011,33(17):961.
 Li Qiying,Min Su.Effects of continuous positive airway pressure on oxygenation and shunt fraction during one-lung ventilation in thoracoscopy and laparoscopy-assisted radical treatment of esophageal carcinoma[J].J Third Mil Med Univ,2011,33(17):1065.
 Chen Huanwen,Du Ming,Wu Qingchen,et al.Application of artificial pneumothorax in thoracoscopic and laparoscopic resection of esophageal carcinoma[J].J Third Mil Med Univ,2012,34(17):789.
 Chen Huanwen,Du Ming,Wu Qingchen,et al.Learning curve of esophagectomy with thoracoscopy and laparoscopy for esophageal carcinoma[J].J Third Mil Med Univ,2012,34(17):1237.

更新日期/Last Update: 2021-09-03