结核性包裹性胸膜炎局麻下胸腔镜治疗的效果研究

Research of effect by thoracoscope with local anesthesia in the treatment of tuberculous encysted pleurisy

目的探讨局部麻醉(局麻)下应用胸腔镜技术治疗结核性包裹性胸膜炎的临床效果。方法 80例结核性包裹性胸膜炎患者,以就诊顺序奇偶分为对照组与研究组,各40例。对照组按照常规胸穿注射治疗,研究组采取局麻下胸腔镜治疗。两组患者均进行2个月以上随访,观察记录两组患者临床效果、随访2个月时胸闷气短症状与胸液消失率,以及治疗前与随访2个月时胸膜厚度、用力肺活量占预计值百分比(FVC%)、补呼气量占预计值百分比(ERV%),并对比分析。结果研究组总有效率100.00%显著高于对照组的80.00%(P<0.05)。研究组随访2个月时胸闷气短消失率100.00%、胸液消失率95.00%均明显高于对照组82.50%、80.00%(P<0.05)。随访2个月时,两组胸膜厚度、FVC%、ERV%均较治疗前改善(P<0.05),且研究组较对照组改善更显著(P<0.05)。结论局麻下应用胸腔镜技术治疗结核性包裹性胸膜炎有不错效果,症状消失快,患者肺功能改善更明显,值得借鉴。

Objective To investigate clinical effect by thoracoscope with local anesthesia in the treatment of tuberculous encysted pleurisy. Methods A total of 80 patients with tuberculous encysted pleurisy were divided by treatment order into control group and research group, with 40 cases in each group. The control group received conventional thoracentesis injection for treatment, and the research group received thoracoscope with local anesthesia. Both groups received follow-up for over 2 months. Observation and records were made on clinical effects, elimination rate of dyspnea and chest fluid after 2-month follow-up, pleura thickness, forced vital capacity percentage predicted value（FVC%） and expiratory reserve volume percentage predicted value（ERV%） during treatment and follow-up for comparative analysis. Results The research group had higher total effective rate as 100.00% than 80.00% in the control group（P〈0.05）. After 2 months of follow-up, the research group had all much higher elimination rate of dyspnea as 100.00% and of chest fluid as 95.00% than 82.50% and 80.00% in the control group（P〈0.05）. Both groups had improved pleura thickness, FVC% and ERV% after 2-month follow-up（P〈0.05）, and the research group had better improvement than the control group（P〈0.05）. Conclusion Implement of thoracoscope with local anesthesia in the treatment of tuberculous encysted pleurisy shows excellent effect, quick symptom elimination, and remarkable improvement of pulmonary function in patients. It is worth reference.