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病人男,60岁。胸闷、气促1年半。查体:左侧胸廓略塌陷,呼吸动度弱,叩诊实音,左肺呼吸音消失;右肺未闻及干湿性哕音。X 线胸片示左肺不张,右肺膨胀,纵隔左移,左膈肌上升。胸部 CT 三维重建见左肺不张,右肺膨胀,纵隔左移(图1)。纤维支气管镜检查示左主支气管被肿瘤完全阻塞。术前诊断:左主支气管肿瘤并左全肺不张、实变。2005年11月在双腔气管插管全麻下手术。术中见左胸
Male patient, 60 years old. Chest tightness, shortness of breath 1 and a half years. Physical examination: the left thorax slightly collapsed, respiratory motion weakness, percussion real sound, left lung breath sounds disappear; the right lung did not smell and wet and dry 哕 sound. X-ray showed left atelectasis, right lung swelling, left mediastinum, left diaphragm rise. Thoracic CT three-dimensional reconstruction of the left lung atelectasis, right lung expansion, left mediastinum (Figure 1). Bronchoscopy showed complete destruction of the left main bronchus by the tumor. Preoperative diagnosis: left main bronchial tumor and left atelectasis, consolidation. November 2005 in double-lumen intubation general anesthesia surgery. See surgery left chest