胸腔镜辅助小切口在慢性包裹性结核性脓胸手术中的应用

doi:10.3969/j.issn.1000-6621.2018.12.005

摘要/Abstract

摘要：

目的探讨胸腔镜辅助小切口在慢性包裹性结核性脓胸手术中的应用经验及疗效。方法回顾性分析2006年1月至2016年12月山东大学附属山东省胸科医院采用胸腔镜辅助小切口施行胸膜剥脱术治疗的164例患者的临床资料。其中男 103例,女61例;年龄6~65岁,平均(31.0±3.7)岁;病史3~18个月,平均(5.0±1.7)个月。对患者术中情况、术后并发症处理,以及治疗转归进行总结分析。结果 164例患者均经一次手术治愈,无围手术期死亡患者。13例患者出现不同程度的心律失常,经对症处理后治愈;15例发生迁延性肺漏气,经过继续胸腔闭式引流后治愈;9例切口愈合不良,经过换药护理治愈。结论胸腔镜辅助小切口对慢性包裹性结核性脓胸的手术治疗,较好地兼顾了微创、效率和安全性,是可选择的一种较为合理的手术方式。

关键词: 结核, 肺, 脓胸, 结核性, 胸腔镜检查, 胸外科手术, 电视辅助, 外科手术, 微创性, 治疗结果

Abstract:

Objective To explore the experience and curative effect of thoracoscope assisted small incision in treatment of chronic tuberculous encapsulated empyema. Methods One hundred and sixty-four patients of local chronic encapsulated tuberculous empyema were treated surgically in Shandong Provincial Chest Hospital between January 2006 and December 2016. Pleurodesis were done by thoracoscope assisted small incision 103 male cases and 61 female cases were enrolled; Aged 6-65 years, the average age were (31.0±3.7)years; 3-18monthes history, the mean history were (5.0±1.7)monthes. Retrospective analysis patients’s intraoperative situation, postoperative complications, and the treatment outcome. Results All patients have no perioperative death, 164 patients were cured by surgery. 13 cases were complicated by different degree of arrhythmia and cured by symptomatic treatment. 15 cases of pulmonary leakage cured by continous chest closed drainage. 9 cases of poor healing of incision were cured by surgical dressing. Conclusion Thoracoscope assisted small incision in treatment of chronic tuberculous encapsulated empyema is a kind of reasonable choice of surgical approach which can ensure the curative effect and safety and reduce the invasiveness

Key words: Tuberculosis, pulmonary, Empyema, tuberculous, Thoracoscopy, Thoracic surgery, video-assisted, Surgical procedures, minimally invasive, Treatment outcome

王成,金锋. 胸腔镜辅助小切口在慢性包裹性结核性脓胸手术中的应用[J]. 中国防痨杂志, 2018, 40(12): 1267-1270. doi: 10.3969/j.issn.1000-6621.2018.12.005

WANG Cheng,JIN Feng.. The application of thoracoscope assisted small incision in treatment of chronic tuberculous encapsulated empyema[J]. Chinese Journal of Antituberculosis, 2018, 40(12): 1267-1270. doi: 10.3969/j.issn.1000-6621.2018.12.005

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