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中国防痨杂志 ›› 2010, Vol. 32 ›› Issue (3): 144-146.

• 论著 • 上一篇    下一篇

112例结核性脓胸的外科治疗分析

龚昌帆, 白连启, 闫东杰, 窦学军   

  1. 北京胸科医院胸外科,北京,101149
  • 出版日期:2010-03-20 发布日期:2010-03-20

Analysis on surgical resection in 112 cases with tuberculous empyema

Gong Changfan,Bai Lianqi,Yan Dongjie,Dou Xuejun   

  1. Beijing Chest Hospital,Chest Surgery Department,Beijing 101149,China
  • Online:2010-03-20 Published:2010-03-20
  • Contact: Bai Lianqi E-mail:bailianqi6@hotmail.com

摘要: 目的 探讨结核性脓胸的外科治疗效果和手术适应症。 方法 总结北京胸科医院1999年1月—2008年底手术切除的112例结核性脓胸的临床疗效。全组包括:结核性全脓胸49例、肺结核合并结核性全脓胸1例、结核性包裹性脓胸53例、肺结核合并结核性包裹性脓胸3例、结核性脓胸合并支气管胸膜瘘6例。 结果胸膜纤维板剥脱术67例、胸膜全肺切除术10例、胸膜肺叶切除术4例、胸膜肺部分切除术6例、胸膜纤维板剥脱+胸廓成形术18例,其他手术7例。总治愈率95.0%,手术并发症率12.5%,死亡率0.9%。 结论 患者一旦发展成慢性结核性脓胸应及早外科治疗,手术是治疗慢性结核性脓胸的唯一有效方法

关键词: 脓胸, 结核性/外科学

Abstract: Objective To explore the efficacy and indication of surgical resection in tuberculous empyema.  Methods 112 patients with tuberculous empyema hospitalized from January 1999 to the end of 2008 receivedsurgical resection therapy. All patients included 49 cases with complete tuberculous empyema, 1 case with pulmonary tuberculosis combined with complete tuberculous empyema,53 cases with tuberculous encapsulated empyema, 3 cases with pulmonary tuberculosis combined with encapsulated empyema and 6 cases with tuberculous empyema combined with broncho pleural fistula.  Results The modes of surgical treatment included: pleural fibrotic plastictomy in 67 cases, pleuropneumonectomy in 10 cases, pleurolobectomy in 4 cases, pleuropneumoresection in 6 cases, pleural fibrotic plastictomy combined with thoracoplasty in 18 cases and other operations in 7 cases. The overall clinical cure rate was 95.0%. The rate of complication was 12.5%. The mortality was 0.9%.   Conclusion s The operation should be performed as eraly as possible when patients developed chronic tuberculous empyema. Surgical therapy is the only effective way in chronic tuberculous empyema.