内镜下治疗纤维空洞型肺结核继发曲菌感染的分析

Clinical Analysis of Endoscope-Assisted Therapy in the Treatment of Secondary Aspergillus Infection Caused by the Fibro-Cavernous Pulmonary Tuberculosis

目的为有效治疗肺结核继发曲菌感染,临床探究使用内镜辅助治疗纤维空洞型肺结核引发的肺曲霉感染的可行性、有效性。方法选取我院2015年6月至2016年6月期间80例经诊断为肺曲霉感染入院治疗的患者,按双盲法随机分为两组包括对照组40例和观察组40例。对照组使用小切口肺叶切除术治疗,观察组行胸腔镜辅助小切口肺叶切除术,观察两组手术情况,对术后不良反应情况进行统计比较。结果观察组在出血量、住院时间、术后疼痛、胸腔引流量方面均优于照组,对照组较观察组手术用时少(P<0.05);对照组较观察组切口感染、肩关节活动障碍、心律失常不良反应多(P<0.05),肺感染、肺不张两组比较无统计学意义(P>0.05)。结论临床在对纤维空洞型肺结核继发曲菌感染患者治疗时,选择内镜辅助不仅能减少手术时间、出血量,同时能降低患者术后疼痛感、不良反应。

Objective To effectively cure the secondary aspergillus infection and explore the feasibility and effectiveness of endoscope assisted therapy in the treatment of secondary aspergillus infection caused by the fibro-cavernous pulmonary tuberculosis. Methods 110 patients with aspergillus infection treated from June 2013 to June 2014 in our hospital were selected.The subjects were randomly divided into two groups,55 cases each group.The control group adopted the pulmonary lobectomy;the observation group adopted the pulmonary lobectomy based on the video-assisted thoracoscopic surgery;the operation condition and adverse reac- tions for two groups were observed.Results The bleeding volume,hospitalization time,postoperative pain,amount of thoracic cavity drainage for observation group was better than control group;the operation time of observation group was longer than control group （P〈O.05） ;the incidence rate of adverse reactions like incision infection, shoulder dysfunction and arrhythmia for control group was higher than observation group （P〈0.05） ; the incidence rate of pulmonary infection and atelectasis for two groups was not significantly different （P〈0.05）.Conclusion For patients with secondary aspergillus infection caused by the fibro-cavernous pulmonary tubercu- losis ,the endoscope-assisted therapy can shorten the operation time, reduce the bleeding volume and reduce the pain degree and adverse event rate.