肺结核之肺切除术

Pulmonary resections in surgical treatment of lung tuberculosis

目的总结肺结核肺切除术的手术适应症及经验。方法2000年～2006年,252例肺结核患者接受手术治疗,其中全肺切除术17例,复合肺叶切除术10例,肺叶切除术148例,局限性肺切除术77例;空洞性病变86例,结核球或干酪灶115例,支气管病变或肺不可逆病变32例,毁损肺19例。结果手术死亡2例,痰菌阴转率92.9%,一次手术治愈率92.5%,复发率4.0%,术后发生支气管胸膜瘘11例(4.4%),结核播散6例(2.4%)。结论肺切除术是治疗特殊类型肺结核的有效手段,但应准确掌握手术适应症、把握手术时机。

Objective To summarize the operative indications and experience of pulmonary resections in surgical treatment of lung tuberculosis. Methods From 2000 to 2005, pulmonary resections were performed on 252 patients with lung tuberculosis, including pulmonectomy in 17 cases, bilobectomy in 10, lobectomy in 148 and limited pulmonary resection in 77. There were 86 patients with intrapulmonary cavitary lesions, 115 with pulmonary tuberculoma, 32 with bronchiectasia and bronchogenie stenosis, 19 with signal destroyed lung. Results The postoperative death occurred in 2 cases. The sputum negative conversion rate was 92. 9% and the cure rate was 92. 5% by one operation. There were 10 patients with recurrence pulmonary tuberculosis and 11 with bronchial fistula and 6 with tuberculosis spreading. Conclusions The pulmonary resection is an effective procedure for special type pulmonary tuberculosis. It is important to choose the operative indication and operation time.