胸膜纤维板剥脱术治疗慢性脓胸23例分析

Analysis of 23 cases of chronic pyothorax cured by decortication of lung

目的探讨如何选择胸膜纤维板剥脱术及其改良术式治疗慢性脓胸,并观察疗效。方法回顾性分析2000至2007年我院采用胸膜纤维板剥脱术治疗23例慢性脓胸患者的疗效。结果全组采用传统胸膜纤维板剥脱术1例;仅行脏层胸膜12例,脏层胸膜纤维板剥除加壁层纤维网状切开术10例,加作肺叶切除1例。术后脓腔全部消灭,脓胸全部治疗愈,全组无死亡病例。结论胸膜纤维板剥脱术是治疗慢性脓胸的有效方法。纤维板形成初期由于质地疏松,容易剥脱,宜选传统的胸膜纤维板剥除术将脏、壁层胸膜及脓腔整块切除;病史长者,粘连致密,剥离困难,可选用改良术式,仅作脏层纤维板剥除,壁层胸膜纤维板不作处理或网状切开,亦可达到满意疗效。

Objective To inquire into the methods of choosing traditional pleural decortication or improved pulmonary decortication to cure chronic pyothorax, and observe the curative effective. Methods Reviewed and analysed 23 eases of chronic pyothorax admitted our hospital from 2000 to 2007 and cured through decortication of lung. Results Among 23 eases ,only one wasa treated with traditional pleural decortication, and pleural fiberboard and abscess were removed entirely. Twelve cases were cured through pulmonary decortication. Ten patients visceral pleura were peeled, and parietal pleura were loosen. One patient received puhnonary lobectomy. Conclusion Peeling pleural fiberboard is an effective measure to cure chronic pyothorax. At the initial stage of the disease, the fiberboard is loosen, it is suitable to remove the visceral and parietal fiberboard and abscess entirely. If the medical history is too long and the fiberboard is too hard to deprive,it is suitable to choose improved pulmonary decortication,and the parital pleural fiberboard might be or be left without any management. It also has a good curative effctive.