改良式胸膜剥脱术治疗慢性结核性脓胸的效果

Effect of modified pleural stripping operation in treating chronic tubercu-lous empyema

目的探讨改良式胸膜剥脱术治疗慢性结核性脓胸对减少术中出血量、降低手术费用的作用。方法随机选取2012年3月-2014年3月陕西省结核病防治院收治的98例慢性结核性脓胸患者,依据治疗方法将其分为观察组和对照组,每组各49例。观察组患者予以改良式胸膜剥脱术治疗,对照组患者予以胸廓成形术治疗。观察并比较两组的术中情况和治疗效果结果与对照组比较,观察组患者的手术时间和留置胸腔引流管时间均明显缩短（P〈0.05）,术中出血量明显减少（P〈0.05）,手术费用明显降低（P〈0.05）;观察组患者治疗的总有效率（98.0%,48/49）明显高于对照组（69.4%,34/49）,差异有统计学意义（P〈0.05）;观察组患者的术后不良反应发生率（12.2%,6/49）明显低于对照组（26.5%,13/49）,差异有统计学意义（P〈0.05）。结论改良式胸膜剥脱术治疗慢性结核性脓胸能够减少患者的术中出血量,减少手术费用。

Objective To investigate the role of modified pleural stripping operation in reducing blood loss and the cost of surgery in the treatment of chronic tuberculous empyema. Methods From March 2012 to March 2014, 98 patients with chronic tuberculous empyema in Tuberculosis Prevention Hospital of Shaanxi Province were selected and divided into observation group（49 cases） and control group（49 cases） according to the treatment methods. The observation group was given modified pleural stripping operation, while the control group was given thoracoplasty operation. The intraoperation situation and treatment effect of two groups were observed and compared. Results Compared with the control group, operative time, chest tube retention time of the observation group was significantly shorter（P〈0.05）, the blood loss was significantly less（P〈0.05）, the surgery cost was significantly lower（P〈0.05）; the treatment total efficiency of the observation group（98.0%, 48/49） was significantly higher than that of the control group（69.4%, 34/49）,the difference was statistically significant（P〈0.05）; the postoperative incidence of adverse reactions（12.2%, 6/49） was significantly lower than that of the control group（26.5%, 13/49）, the difference was statistically significant（P〈0.05）.Conclusion Modified pleural stripping operation can reduce patients＇ blood loss and operation cost in treating chronic tuberculous empyema.