视屏胸腔镜下胸腔留置浸洗治疗肺结核术后重症胸腔感染的效果

Efficacy of indwelling chest dip in treatment of severe chest infection after tuberculosis under screen thoracoscope

目的探讨肺结核术后采用胸腔留置浸洗方法治疗胸腔感染,并与传统胸腔冲洗的方法进行比较。方法胸腔留置浸洗组12例,分为不伴支气管胸膜瘘组和伴有支气管胸膜瘘组,胸腔冲洗患者19例作为对照组。结果胸腔留置浸洗组经治疗后所有患者均治愈,治愈率达100.0%;胸腔冲洗组经治疗,除1例大咯血死亡,治愈率94.7%,2组患者住院日比较,差异有统计学意义(P<0.05)。结论通过视屏胸腔镜引导下,行残腔充填浸洗药物溶液并延长药物作用时间,可彻底消除残腔内壁的感染病灶,感染残腔变为灭菌残腔而达到临床治愈,显著提高肺切除术后难治性胸腔感染的临床治愈率,使该项术后并发症的临床治疗达到微创化水平。

OBJECTIVE To explore the treatment of tuberculosis infection after the chest chest lien dip compared with traditional chest flush.METHODS A total of 21 cases of patients with chest lien dip group,male in 12 cases,female 9 cases,42-71 years,mean age 55.1 years,pneumonectomy in 6,with BPF in 7 cases,divided into without BPF group and accompanied by BPF groups chest lien dip.In 19 patients for pleuroclysis group as a comparison,male 13 cases,female in 6,21-61 years,mean age 41.2 years,with pneumonectomy in 5 patients,and accompanied by BPF 5 an example pleuroclysis.RESULTS Dip the chest lien method above all patients were cured,cure rate reached 100%,no long-term retention chest closed drainage.By the above method pleuroclysis group except one big coughing up blood death,cure rate 94.7%,no long-term retention chest closed drainage（P〈0.05）.CONCLUSION Through the video guide descending the cavity vats filling dip drug solution and prolong drug effect of time,it can eliminate the residual cavity wall of catching a disease,infections residual cavity into sterilization and achieve a clinical cure the cavity,increase significantly after pneumonectomy chest infection refractory clinical cure rate,make the clinical treatment of postoperative complications to minimally invasive on level.