传统方法与胸腔镜处理小儿脓胸的比较分析

Comparative Study of Conventional Therapy and Video-Assisted Thoracoscopic Surgery for Empyema Thoracis in Children

目的 评价不同治疗方法对小儿脓胸的治疗价值。方法 将 9年中 4 3例小儿脓胸分为用传统方法 (A组 )和电视胸腔镜手术 (B组 )处理两组 ,对其术后各种参数进行回顾性分析。结果 两组并发症的发生率和死亡率差异无显著性 (P >0 .0 5 ) ,但术后发热时间、抗生素应用时间、胸管留置时间和住院时间B组均短于A组[(2 .8± 1.7)dvs (5 .7± 2 .1)d ,(7.6± 2 .5 )dvs (13.8± 4 .7)d ,(3.8± 1.6 )dvs (5 .8± 2 .4 )d ,(10 .4± 3.0 )dvs (17.8± 5 .6 )d](P <0 .0 1)。结论 电视胸腔镜处理小儿脓胸创伤小 ,疗效好 ,疗程短 。

Objective To evaluate the value of video-assisted thoracospic surgery (VATS) for the treatment of pediatric empyema thoracis. Methods Forty three children with empyema thoracis between January, 1992 and February, 2001, over a period of 9 years, were treated by conventional therapy (thoracentesis, chest tube drainage or thoracotomy debridement; Group A, n=28) and VATS (Group B, n=15). Postoperative parameters of the two groups were reviewed retrospectively. Results The duration of fever, antibiotical therapy, chest tube drainage and hospitalization in Group B was shorter than those in Group A [( 2.8 d ± 1.7 ) d vs ( 5.7 ± 2.1 ) d, ( 7.6 ± 2.5 ) d vs ( 13.8 ± 4.7 ) d, ( 3.8 ± 1.6 ) d vs ( 5.8 ± 2.4 ) d, ( 10.4 ± 3.0 ) d vs ( 17.8 ± 5.6 ) d, respectively] (P< 0.01 ). There was no difference in the incidence of postoperative complications and in mortality between the two groups. Conclusions VATS for empyema thoracis was efficacious and less traumatic, and the duration of treatment was short. However, the treatment should be intervened as early as possible.