关键词: 肝硬化, 脓胸, 结核性, 胸外科手术, 治疗结果

Abstract:

Objective To evaluate the efficacy of surgical treatment of tuberculous empyema complicated with static cirrhosis.Methods Thirty-six patients who were suffering from tuberculous empyema complicated with static cirrhosis were enrolled from April 2013 to April 2018 in Xi’an Chest Hospital. The tuberculous empyema lesions were removed and the pleural resection was performed. The patient’s operation time, intraoperative blood loss, postoperative drainage volume, tube time, pulmonary complications, postoperative hospitalization time, and lung function changes were analyzed.Results The intraoperative blood loss, total 3 days postoperative drainage volume, postoperative tube time, and postoperative chest infection rate were (423.6±32.8)ml, (664.8±49.9)ml, (5.6±1.2)d, 16.7% (6/36). The postoperative pulmonary function index after 3 months were following: the forced vital capacity (FVC) was (90.6±8.6)%; the first expiratory volume (FEV1) was (85.0±6.6)%; the maximum expiratory peak flow rate (PEF) was (72.9±2.7)%; the ventilation volume (MVV) was (84.7±4.4)%, compared with the preoperative index ((68.9±7.5)%, (63.5±5.6)%, (64.1±3.6)%, (61.6±4.1)%), the difference was statistically significant (t=-11.37, P<0.01; t=-10.94, P<0.01; t=-13.36, P<0.01; t=-21.14, P<0.01). Thirty-six patients were followed up for 9 months and the symptoms disappeared; 34 wounds healed by first intention, 2 cases delayed healing and healed after 1 month with local dressing change. No recurrence patients.Conclusion Surgical treatment of static cirrhosis with tuberculous empyema is safe, feasible and effective. There is no cirrhosis activity and tuberculosis dissemination, but intraoperative blood loss and postoperative drainage volume should be vigilant.

Key words: Liver cirrhosis, Empyema, tuberculous, Thoracic surgical procedures, Treatment outcome