电视胸腔镜在非机化期脓胸中的应用

Application of video-assisted thoracoscopy in treatment of nonorganizational pleural empyema

目的探讨电视胸腔镜(VATS)在非机化期脓胸中的应用价值。方法选取2003年5月至2004年11月应用VATS治疗的非机化期脓胸患者12例作为VATS组,另选同期保守治疗的非机化期脓胸患者19例作为保守组,对两组患者的胸管放置时间、体温恢复至正常时间、白细胞计数降至正常时间及治疗后住院时间等进行统计分析。结果VATS组12例患者均治愈,保守组13例患者治愈,两组均无1例患者死亡。VATS组胸管引流、体温恢复正常、白细胞计数恢复正常的时间及治疗后住院天数分别为术后(4.6±1.1)、(3.8±0.8)、(6.5±0.9)和(8.8±1.5)d,均显著短于保守组的(19.1±2.4)、(9.4±1.1)、(13.3±1.0)和(21.5±2.7)d (P值均<0.05)。结论VATS脓胸清除术具有创伤小、视野好和安全性高的优点。早期应用于非机化期脓胸的治疗符合急性脓胸的治疗原则,可及时、有效地控制病情,促进患者恢复,提高治愈率。

Objective To study the value of video-assisted thoracoscopic（VATS） surgery in treatment of nonorganizational pleural empyema（NPE）. Methods Twelve NPE patients who were treated with VATS（May 2003 to Nov. 2004） were taken as experimental group and another 19 NPE patients who were treated by conservative method were taken as conservative group. The duration of chest tube drainage, the recovery time of temperature and leucocytes, and the postoperative hospital stay were compared between the 2 groups. Results All the 12 patients in VATS group were cured and 13 patients in the conservative group were cured; there was no death in either group. The duration of chest tube drainage, the recovery time of temperature, the recovery time of leucocytes, and the postoperative hospital stay were in VATS group were significantly shorter than those of conservative group（[4.6 ± 1. 1] d vs [19.1 ± 2.4] d, [3.8 ± 0.8] d vs [9.4 ± 1.1] d, [6.5 ±0.9] d vs [13.3 ± 1.0] d, and [8.8±1.5] d vs [21. 5± 2. 7] d, respectively. All P〈0.05）. Conclusion VATS has good visual field and good safety when used for patients with nonorganizational pleural empyema; early application of VATS can timely control the disease progression and promote patients＇ recovery, increasing the curative rate.