胸壁结核的临床诊断和治疗(附29例报告)

Clinical diagnosis and treatment of tuberculous abscess in the chest wall(report of 29 cases)

目的总结胸壁结核的临床诊断和治疗方法。方法回顾性分析从1998年10月-2007年1月手术治疗的29例患者的临床资料。结果患者29例,年龄16-68岁,男21例,女8例（男女比例=2.6：1）,有结核病史者6例,8例患者合并有肺结核。所有患者在手术前后均接受了抗结核药物治疗,29例患者中3例进行了胸壁结核脓肿切除,肋骨切除加肌瓣填塞25例,胸廓成形术1例,全部患者随访1-5年无复发。结论胸壁结核脓肿病灶的广泛切除和手术前后抗结核治疗,是防止复发的关键。

Objective To summarized clinical diagnosis and treatment of tuberculous abscess in the chest wall. Methods The records of 29 patients who underwent surgical treatment of tuberculous abscess in the chest wall were retrospectively reviewed between 0ctober1998 to January 2007 in our hospital. Results Their ages ranged from 16 to 68 years, the male to female ratio was 2.6 ： 1 （ male 21, female 8 ）. There was a past history of tuberculosis in 6 patients, concomitant active pulmonary tuberculosis in 8. In all patients, preoperative and postoperative antituberculous treatments wereadministered. All of the patients underwent surgical treatment,3 patients underwent excision of chest wall abscesses,25 patients underwent chest wall and rib resection with muscle flap, 1 patients with thoracoplasty. All patients were followed up from 1 to 5 years, and there was no recurrence. Conclusions In managing tuberculous abscess of the chest wall ,extensive abscess excision with rib resection is considered to be important,perioperative anti - tuberculosis medication may play an important role in reducing the postoperative recurrence.