外穿性脓胸最佳手术时机选择的临床研究

Clinical Study on the Optimal Operation Time of Empyema Necessitatis

目的探讨外穿性脓胸的最佳手术时机。方法回顾性分析河北省胸科医院于2011年1月—2016年1月收治的外穿性脓胸72例的临床资料。根据从出现胸部首发症状到实施手术的时间分为3组,A组<2周,B组2~4周,C组>4周。观察3组手术时间、术中出血量、术后引流量、带管时间、术后住院时间、术后并发症发生情况。结果 A组术中出血量少于B、C组,带管时间、术后住院时间短于B、C组(P<0.05)。3组手术时间、术后引流量、术后并发症发生率比较差异无统计学意义(P>0.05)。结论外穿性脓胸的最佳手术时机为从出现首发症状到手术2周以内,患者术后恢复较快。

Objective To investigate the optimal operation time of empyema necessitates. Methods Clinical data of 72 patients with empyema necessitatis admitted during January 2011 and January 2016 was retrospectively analyzed. The patients were divided into three groups according to duration between having the first symptom of chest and performing operation. Group A was the duration less than 2 weeks ; group B was the duration between 2 to 4 weeks; group C was the duration more than 4 weeks. Operation time, intraoperative bleeding volume, postoperative drainage volume, drainage duration, postoperative hospitalization and incidence rate of postoperative complications were observed in three groups. Results In group A, values of intraoperative bleeding volume, drainage duration and postoperative hospitalization were significantly lower than those in group B and C （P 〈 0. 05）. There were no significant differences in operation time, postoperative drainage volume and incidence rate of postoperative complications among three groups （P 〉 0.05 ）. Conclusion The optimal operation time of empyema necessitates is within two weeks between having the first symptom of chest and performing operation, and patients show quickly postoperative recovery.