经胸腔镜冷冻技术治疗结核性包裹性胸腔积液疗效观察

Efficacy of Thoracoscopic Cryotherpy for Tubercubus Loculated Pleurisy Effusion

目的探讨经内科胸腔镜微创冷冻治疗结核性包裹性胸腔积液的临床疗效。方法对81例结核性包裹性胸腔积液患者通过内科胸腔镜微创检查并对胸腔内纤维粘连的包裹病变采用冷冻探针清除并进行胸腔药物灌洗治疗。结果患者胸腔内均见大量包裹粘连形成,采用冷冻探针与纤维组织粘连后的冻切法可清除胸腔内病变,经治疗后患者症状改善,胸腔积液吸收明显。显效15例(18.52%),有效65例(80.25%),无效1例(1.23%),总有效率98.77%。结论内科胸腔镜能及时发现胸腔内纤维粘连包裹,在胸腔镜直视下能对病变进行清除,冷冻疗法是内镜下治疗胸腔病变的又一有效方法,值得临床推广。

Objective To explore clinical effects of microinvasive cryotherpy via medical thoracoscopy on tuberculous loculated pleurisy effusion.Methods Totally 81 patients with tuberculous loculated pleurisy effusion were enrolled.They all received the treatment with microinvasive detection via medical thoracoscopy,elimination of intrathoracic fibronectin encapsulated lesions by cryoprobe,and pleural lavage of medicine.Results All with the patients had a large amount of intrathoracic encapsulated fibronectin adhesion.The cryoprobe elimination method could eliminate the intrathoracic lesions.The therapy significantly improved the patients′ symptoms and made the hydrothorax reduced obviously.There were 15 cases（18.52%） with marked effect,65（80.25%） with effect,and 1（1.23%） with no effect,total efficiency being 98.77%.Conclusion The application of medical thoracoscopy can timely find intrathoracic fibronectin encapsulated lesion,and resection of the lesion could be done under direct vision with thoracoscope.The cryotherpy is another effective method to treat pleural lesions,being worthy of popularization.