自体胸膜补片在慢性结核性脓胸手术中的应用

Application of autologous pleura patch in surgery for chronic tuberculous empyema

目的探讨自体胸膜补片修复慢性结核性脓胸肺创面的治疗效果。方法河北省胸科医院胸外一科2012年8月至2014年11月收治慢性结核性脓胸患者7例，采用自体胸膜补片修复慢性结核性脓胸手术中肺创面，记录患者术后漏气时间、带胸管时间，复查X线胸片观察肺复张情况，记录随访情况等。结果术后6例患者胸腔闭式引流管有少量气泡引出，未超过10 h；1例漏气，24h后漏气消失。复查x线胸片均显示肺复张良好，术后4—7d拔除胸腔闭式引流管，全组无死亡病例，无胸腔感染，复查胸部CT无明显残腔。随访6—24个月未发生气胸及胸腔感染，无残腔。结论自体胸膜移植覆盖肺创面为较大面积、浅在肺创面的处理提供了一项新的选择，具有推广应用价值。

Objective To explore the efficacy of autologous pleural patch in surgical operation on the patient with chronic tuberculous empyema. Methods Autologous pleura patches were used to repair the pulmonary wound in the surgical operations for 7 patients with chronic tuberculous empyema, who received surgical management in Hebei Provincial Chest Hospital from August 2012 to November 2014. The leak time of the patient and the time of the chest tube were recorded, the pulmonary re-examination was observed by chest X- ray, and the follow-up results were recorded. Results The time of persistent pulmonary air leak of 6 patients was not more than 10 hours after operation, 1 patient was not more than 24 hours. Review of X-ray chest showed that good for lung, 4-7 d after operation removal of thoracic dosed drainage tube, there was no death and no chest infection in 7 patients and review of CT chest showed no significant residual cavity. After follow-up for 6-24 months 7 patients had satisfactory efficacy, there was no pneumothorax and thoracic infection, no residual cavily. Conclusion Autologous pleura can be used to patch the pulmonary wound in the surgical operation on the patient with chronic tuberculous empyema.