胸腔镜局麻下治疗结核性胸膜粘连及包裹

Thoracoscopy Under Local Anesthesia in the Treatment of Tuberculous Pleural Adhesions and Parcel

目的:研究胸腔镜局麻下治疗结核性胸膜粘连及包裹的方法及临床效果。方法:以我院自2014年3月23日-2016年3月23日收治的68例结核性胸膜炎粘连包裹患者为研究对象,采用随机数表法分成两组。观察组接受胸腔镜局麻下粘连分离术治疗,对照组采取常规穿胸水引流术治疗,比较两组临床效果。结果:观察组总有效率(94.12%)高于对照组总有效率(85.29%),组间差异显著(P<0.05)。观察组患者治疗后6个月BORG评分低于治疗后1个月,差异有统计学意义(P<0.05)。观察组患者治疗后1、3、6个月BORG评分均显著低于对照组(P<0.05)。接受治疗后3、6个月,对照组患者BORG评分均低于治疗后1个月,差异均有统计学意义(P<0.05)。观察组患者治疗后6个月FVC水平高于治疗后3个月(P<0.05)。相较于对照组,观察组患者治疗后1、3、6个月FVC水平明显更高(P<0.05)。结论:胸腔镜局麻下治疗结核性胸膜粘连及包裹效果十分显著,可明显改善患者肺功能和临床症状,对患者有利。

Objective： To study the method and clinical effect of thoracoscopy under local anesthesia in the treatment of tuberculous pleural adhesions and parcel. Methods： 68 patients with loculated tuberculous pleurisy in our hospital were selected as research objects and were divided into two groups by random number table. The observation group （n=33） received thoracoscopy under local anesthesia adhesiotomy treatment, while the control group （n=33） were taken routine chest water drainage treatment. Clinical effect of two groups was compared. Results： The total efficiency of the observation group was 94.12%, which was higher than 85.29% of the control group, and the difference was statistically significant （P〈0.05）. BORG score of patients in the observation group at 6 months after treatment were lower than that after 1 month treatment （P〈0.05）. BORG score of observation group afterl, 3 and 6 months treatment were lower significantly than that in the control group （P〈0.05）, respectively. As for control group, BORG scores were after treatment 3, 6 months were lower than the scores at 1 month （P〈0.05）. And 6 month after treatment, FVC levels of patients in the observation group was higher （P〈0.05）, when compared to 3 month. Compared with control group, FVC levels of the patients in the observation group were higher after treatment 1, 3 and 6 months （P〈0.05）. Conclusion： Thoracoscopy under local anesthesia in the treatment of tuberculous pleural adhesions and the package effect is very significant. It can significantly improve lung function and clinical symptoms, which is good for the patient.