[1]金明华,王伟,王传庆等.电视胸腔镜脓胸廓清术治疗结核性脓胸[J].中国微创外科杂志,2012,12(6):524-526.
　Jin Minghua,Wang Wei,Wang Chuanqing,et al.Videoassisted Thoracoscopic Surgery for Tuberculous Empyema[J].Chinese Journal of Minimally Invasive Surgery,2012,12(6):524-526.
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电视胸腔镜脓胸廓清术治疗结核性脓胸()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年6期
页码:
524-526
栏目:
出版日期:
2012-06-15

文章信息/Info

Title:
Videoassisted Thoracoscopic Surgery for Tuberculous Empyema
作者:
金明华; 王伟; 王传庆等
山东省胸科医院胸部微创外科，济南250013
Author(s):
Jin Minghua;  Wang Wei;  Wang Chuanqing;  et al.
Department of Minimally Invasive Surgery, Shangdong Thoracic Hospital, Ji’nan 250013, China
关键词:
脓胸; 结核; 胸腔镜
Keywords:
Empyema; Tuberculosis; Thoracoscopy
分类号:
R655.2
文献标志码:
A
摘要:
目的探讨电视胸腔镜脓胸廓清术治疗结核性脓胸的疗效。方法2004年1月～2011年6月对82例早期结核性脓胸（病史2周～2个月，处于渗出期和纤维机化早期）行电视胸腔镜脓胸廓清术，在胸腔镜下分离粘连，清理脓苔，刮除脏、壁层胸膜上干酪样物、坏死和肉芽组织，剥除增厚的纤维板，术中反复冲洗，术后充分引流、注药，同时全身抗结核治疗。结果82例电视胸腔镜脓胸廓清术均顺利完成，术后5～7 d顺利拔管。术后1个月复查CT示脓腔消失，肺脏膨胀良好；术后1个月痰查结核菌无阴转阳者，术前阳性2例分别于术后1、3个月转阴。术后1个月用力肺活量、第1秒用力肺活量、肺总量与术前相比明显改善（P<0.05）。结论电视胸腔镜脓胸廓清术治疗纤维素期和纤维机化早期的结核性脓胸是安全、有效的方法。
Abstract:
ObjectiveTo evaluate the efficacy of videoassisted thoracoscopic surgery(VATS) for thoracic tuberculous empyema.MethodsFrom January 2004 to June 2011, we performed VATS on 82 patients with early tuberculous empyema (course of disease: 2 weeks to 2 months, in exudative or early fibrosis stage). Under a thoracoscope, we separated adhesions, cleaned up the pus moss, scraped fabric, caseous necrosis and granulation tissues on the parietal and visceral pleurae,and stripped the thickened fiberboard; meanwhile, the surgical field was washed repeatedly. After the procedure, sufficient drainage, injection and antituberculosis therapy were carried out.ResultsThoracic empyema clearance was successfully completed in all the 82 patients, who were extubated smoothly in 5-7 days. One months after the surgery, CT examination showed disappearance of abscess cavity and fine lung expansion. Two patients, who had positive sputum for tubercle bacilli, converted to negative in 1 and 3 months respectively, and no cases converted from negative to positive. FVC, FEV1, and TLC of the patients were improved in one month compared to preoperation(P<0.05).ConclusionVATS is safe and effective for cellulose fiber and early fibrosis stage tuberculous empyema.

参考文献/References:

[1]Nikolaos B, Dimitrios P, Christos A, et al. The role of videoassisted thoracoscopic surgery in the management of tuberculous empyemas. Int Cardiovasc Thorac Surg,2009,8:334-338.
[2]韦成信,黄健辉,刘永春,等.电视胸腔镜辅助胸外科手术治疗脓胸52例.微创医学,2006,1(2):136-137.
[3]唐神结,高文，主编.临床结核病学.第1版.北京:人民卫生出版社,2011.366-376.
[4]周明香,于学燕,徐玉荣,等.内科胸腔镜术辅助治疗结核性脓胸26例疗效观察.泰山医学院学报,2008,29(6):447-449.
[5]卢军,金明华.胸部微创切口治疗结核性脓胸.临床肺科杂志,2005,10(5):610-611.
[6]王钧,吴万鹏,孙明兴,等.电视胸腔镜在结核性脓胸治疗中的作用.天津医药,2010,38(12):1097-1099.
[7]Wurnig PN, Wittmer Ｖ,Pridun NS, et al. Videoassisted thoracic surgery for pleural empyema．Ann Throrac Surg,2006,81(1):309-313.
[8]韦舸,覃洪斌.胸腔镜辅助脓胸手术45例报告.中国微创外科杂志,2007,7(5):491-492.

更新日期/Last Update: 2012-06-15