胸膜外肺空洞切开内翻转在纤维空洞型肺结核治疗中应用研究

Application of extrapleural pneumonectomy empty cut within the flip in treatment of fiber cavitary pulmonary tuberculosis

目的探索运用胸膜外途径进行肺空洞切开内翻转手术方法,治疗纤维空洞型肺结核的临床疗效。方法选取2008年1月-2012年1月就诊的纤维空洞型肺结核确诊患者62例,随机分为观察组32例和对照组30例,对照组患者在规范抗结核治疗的基础上仅给予抗感染、止血、对症治疗;观察组患者给予胸膜外肺空洞切开内翻转手术治疗,其后密切观察患者临床症状,并定期进行痰涂片、X线、血常规、肝肾功能等检查,以评价疗效。结果治疗有效率观察组为71.88%、对照组为53.33%,两组比较观察组显著高于对照组,差异有统计学意义(P<0.01);观察组患者在1个月及3个月时的痰菌阴转率为68.75%和78.13%,均显著高于对照组,差异有统计学意义(P<0.01);在6、9及12个月时观察组患者痰菌阴转率亦明显高于对照组,差异有统计学意义(P<0.05)。结论胸膜外肺空洞切开内翻转治疗方法对于纤维空洞型肺结核具有较佳的临床治疗效果,患者预后较好。

OBJECTIVE To explore the clinical efficacy of the application of extrapleural pneumonectomy empty cut within the flip in the treatment of fiber cavitary pulmonary tuberculosis.METHODS A total of 62 cases of pulmonary tuberculosis patients diagnosed in the hospital from Jan 2008 to Jan 2012 were chosen as the research objects.They were randomly divided into the observation group of 32 cases and the control group of 30 cases.The control group patients were given the antibiotics on the basis of the norms of anti-TB treatment,stop hemostasis,and symptomatic treatment.The observation group was treated with extrapleural pneumonectomy empty cut flip open within the surgical treatment.The clinical symptoms after the end of treatment were taken for regular observation and the sputum of patients,X-ray,blood,liver and kidney function were taken for regularly check for the efficacy evaluation.RESULTS The treatment effective rate of the observation group was 71.88%.The control group was 53.33%.Compared with the two groups,the observation group was significantly higher,the difference was statistically significant（P0.01）.The negative conversion rates of the sputum bacteria within one and three months were 68.75% and 78.13%,both of which were significantly higher than that of the control group,the difference was statistically significant（P0.01）.The negative conversion rates of the sputum bacteria within six,nine,and twelve months were significantly higher in the observation group than in the control group,the difference was statistically significant（P0.05）.CONCLUSION The extrapleural pneumonectomy empty cut within the flip can achieve good clinical efficacy in the treatment of fiber cavitary pulmonary tuberculosis,and it is conducive to the prognosis.