全肺切除治疗结核性毁损肺的临床疗效分析

Clinical effect analysis of pneumonectomy for tuberculosis-destroyed lungs

目的评价结核性毁损肺(毁损肺)行全肺切除手术的疗效。方法回顾性分析2000年4月至2010年9月122例行全肺切除治疗毁损肺的临床疗效,左毁损肺86例,右毁损肺36例。结果全肺切除术82例,胸膜全肺切除术33例,全肺切除+支气管胸膜瘘(BPF)修补术2例,胸膜全肺切除+BPF修补术2例,全肺切除+胸廓成形术1例,全肺切除+气管成形术2例。临床治愈率为86.9%(106/122),痰菌阴转率为91.0%(111/122),围手术期病死率为3.3%(4/122),手术并发症发生率为9.0%(11/122)。结论严格把握手术适应证、术前规范的抗结核治疗的基础上行全肺切除术治疗毁损肺的效果令人满意。

Objective To evaluate the effect of pneumonectomy for the treatment of tuberculosis-destroyed lungs. Methods Retrospective analysis of treatment efficacy was performed on 122 cases of tuberculosis-destroyed lungs treated with pneumoneetomy in the Thoracic Surgery Department of Beijing Chest Hospital from April 2000 to September 2010. There were 86 patients with destroyed lungs in the left side, 36 patients in the fight side. Results In all cases, 82 cases underwent pneumoneetomy, and 33 cases underwent pleuropneumoneetomy, 2 eases underwent pneumonectomy plus bronchopleural fistula （BPF） repair, 2 eases underwent pleuropneumonectomy plus BPF repair, 1 case underwent pneumonectomy plus thoracoplasty, 2 cases underwent pneumonectomy plus traeheoplasty. The clinical cure rate was 86.9% （106/122） and the sputum negative conversion rate was 91.0% （111/122）. The overall perioperative mortality rate was 3.3% （4/122）. The surgery complication rate was 9.0% （11/122）. Conclusions Pneumonectomy efficacy for destroyed lungs is satisfactory if strict surgical indications were applied and standard preoperative anti-tuberculosis treatment was carried out.