78例结核性脓胸的外科治疗

Surgical therapy for 78cases with tuberculous empyema

目的探讨外科治疗结核性脓胸的方法及治疗效果。方法回顾分析2007年1月至2012年12月航天中心医院胸外科和北京胸科医院胸外科78例患者的手术治疗情况和手术疗效。结果术后肺复张良好67例(85.9%);肺复张较差11例(14.1%),及时行纤维支气管镜吸痰后肺复张。术后发生并发症7例(9.0%),包括术后胸腔内出血1例,伤口感染1例,药物性肝炎伴水电解质紊乱1例;均经相应治疗痊愈。呼吸衰竭4例,经呼吸机抢救3例成功,1例死亡,病死率1.3%。术后抗结核治疗6个月至2年,1例患者6个月后肺部感染,经抗炎治疗好转。术后随访2年,77例患者均好转。结论外科手术治疗结核性脓胸可以取得满意疗效。

Objective To investigate the outcome of patients with tuberculous empyema who underwent sur- gery. Methods We analyzed retrospectively the data from 78 patients with tuberculous empyema admitted and un- dergone surgical operation in the Aerospace Center Hospital and Beijing Chest Hospital during January 2007 and De cember 2012. Results Postoperative complications occurred in 7 patients（9.0%）, including internal hemorrhage, wound infection and drug-induced hepatitis accompany with fluid and electrolyte imbalance in a different patient, they were recovered after treatment. In addition, respiratory failure in 4 patients, 3 of which were cured by treating with breathing machine and 1 patient died. Mortality was 1.3%. Seventy seven patients received antitubereulous drug treatment for 6 months to 24 months. One patient suffered from pneumonia in six months and then recovered with anti-inflammatory therapy. After follow-up for 2 years, 77 patients had satisfactory efficacy. Conclusion Surgical operation treating with tuberculous empyema would give the best chance of cure with less complications.