胸部小切口胸膜纤维板剥脱术治疗慢性结核性脓胸

Decortication treatment for chronic tuberculous empyema via minithoracotomy

目的 总结经胸部小切口胸膜纤维板剥脱术治疗慢性结核性脓胸的临床经验。方法 对18例慢性结核性脓胸患者行经胸部小切口胸膜纤维板剥脱术治疗，手术切口长度为8—15cm。结果 16例在小切口范围内完成手术，2例因胸腔内粘连紧密，分离时失血多而中转为常规切口手术。术后第1天出现血胸1例，经原切口血块清除＋止血术后治愈。出院前胸片复查18例患者，患侧胸部脓腔均消失，肺脏均膨胀良好，无围术期死亡。结论 胸部小切口胸膜纤维板剥脱术适合于刚进入慢性阶段的结核性脓胸患者。

Objective To summarize the experience of decortication treatment for chronic tuberculous empyema. Methods From June 2003 to June 2006,18 patients who were diagnosed chronic tuberculous empyema received decortication via minithoraeotomy,the length of incisions ranged from 8 to 15cm. Results Sixteen patients were fin- ished procedures by minithoracotomy,2 patients received another conventional thoracotomy due to tight adherence and mass blood loss. There was no perioperative death. The postoperative complication was 1 case of hemothorax on the first day after operation,and was cured by reopening chest to clean the hemothorax and performing hemostasis. Before discharge, aU patients received x-ray examination of the chest. It showed that the abscess disappeared and hngs irflated well,No perioperative deaths. Conclusion Decortication treatment for chronic tuberculous empyema via minithoraeotomy is suitable for early-stage chronic tuberculous empyema.