胸腔镜引流纤维板剥脱术治疗脓胸的手术时机

The timing of thoracoscopic drainage and decortication for empyema

目的:探讨脓胸行胸腔镜引流、纤维板剥脱术的手术时机。方法:回顾分析2015年3月至2020年6月接受全麻胸腔镜引流、纤维板剥脱治疗的126例脓胸患者的临床资料,根据胸部症状出现至手术的时间间隔分为三组:第1组(<2周,n=76)、第2组(2~4周,n=35)、第3组(>4周,n=15),分析比较症状持续时间与临床结果的相关性。结果:第1组与第2组手术时间、胸管引流时间、术后住院时间、漏气率均优于第3组,第1组与第2组间差异无统计学意义;3组术后重症监护室停留时间及再干预、再手术率差异无统计学意义。结论:症状持续时间少于4周的患者较大于4周的患者可显示出更好的临床结果,脓胸于4周内行胸腔镜引流、纤维板剥脱术效果更佳。

Objective:To explore the optimal timing of thoracoscopic drainage and decortication for empyema.Methods:From Mar.2015 to Jun.2020,one hundred and twenty-six patients with empyema were treated with thoracoscopic drainage and decortication.The patients were divided into 3 groups based on the interval between the onset of chest symptoms and the time of operation:group 1(<2 weeks,n=76),group 2(2 to 4 weeks,n=35)and group 3(>4 weeks,n=15).The correlation between symptoms duration and clinical outcomes was analyzed.Results:Groups 1 and 2 showed less chest tube duration,postoperative hospital stay,surgical time and incidence of air leak than group 3,there was no significant difference between group 1 and group 2.No difference was found in the postoperative intensive care unit stay or incidence of re-intervention and re-operation among the 3 groups.Conclusions:Patients with symptoms duration of less than 4 weeks show better results than those with symptoms duration greater than 4 weeks.Thus,for empyema within 4 weeks,the effect of thoracoscopic drainage and decortication is better.