电视胸腔镜胸膜固定术治疗恶性胸腔积液的疗效观察

Clinical application of pleurodesis with video-assisted thoracoscopic surgery in the treatment of malignant pleural effusion

目的探讨电视胸腔镜胸膜固定术治疗恶性胸腔积液的疗效。方法选取我院因各种原因导致并经病理诊断确诊为恶性胸腔积液的患者50例,随机分为两组,观察组采用电视胸腔镜胸膜固定术治疗,对照组采用胸腔闭式引流手术治疗。观察两组患者有效率、缓解率情况,以及胸腔积液中白细胞、总蛋白定量及乳酸脱氢酶(LDH)的改善情况。结果观察组患者总有效率为96.0%,完全缓解率为92.0%,明显高于对照组的64.0%和32.0%,差异具有统计学意义,P<0.05。且治疗后两组患者积液检查的白细胞、蛋白含量以及乳酸脱氢酶的量都显著降低,但观察组降低幅度明显高于对照组,差异具有统计学意义。P<0.05。结论电视胸腔镜胸膜固定术治疗恶性胸腔积液效果显著,且安全性高,值得推荐。

Objective To investigate the clinical effect of pleurodesis with video-assisted thoracoscopic surgery （VATS） in the treatment of malignant pleural effusion. Methods 50 patients in our hospital with malignant pleural effusion were randomly divided into two groups. The experiment group was treated with VATS, and the control group was given closed thoracic drainage combined with thoracic injection with talc powder. The improvement of efficiency, response rate, and pleural effusion leukocytes was observed and compared be- tween the two groups. Results The total, effieaecy was 96.0% and the complete reraission rate was 92. 0% in the experiment group, which was obviously higher than those in the control group （64.0% and 32. 0% respectively） （ P 〈 O. 05 ）. The total white cells, protein and lactate dehydrogenase （LDH） decreased more obviously in the experiment group than in the control group with significant difference （P 〈 0. 05 ）. Conclusion VATS is a safe and minimal invasive procedure in the treatment of malignant pleural effusion.