彻底性纤维板剥脱治疗慢性机化性脓胸临床疗效

Efficacy and Safety Assessment of Complete Decortication of Pleural Fibreboard in Treating Chronic Organized Pleural Empyema

目的回顾性分析彻底性剥除慢性机化性脓胸纤维板的安全性及临床疗效。方法收集我院2013年1月至2020年4月患有慢性机化性脓胸并实施纤维板剥脱术的患者63例,根据手术方法不同分为试验组39例实施彻底性纤维板剥脱术;对照组24例行非彻底性的纤维板剥除术。对比两组手术时间,手术出血量,住院时间,术后效果等临床疗效情况。结果所有患者均康复出院,试验组患者肺复张程度、肺功能改善情况、胸廓形态纠正程度等方面均获得了显著改善,对照组患者有15例残腔消失,9例残腔显著缩小但未消失。胸廓形态恢复程度及呼吸功能等方面两组差异有统计学意义。结论对于不伴有毁损肺的慢性机化性脓胸患者,不论病史长短,实施彻底性纤维板剥脱术是安全可行的;实施彻底性纤维板剥脱术能显著改善患者的术后效果。

Objective To retrospectively analyze the safety and surgical effects of thorough fiberboard decortication surgery to treat chronic calcified pleural empyema.Methods From January 2013 to April 2020,total 63 patients diagnosed as chronic calcified pleural empyema and underwent fiberboard decortication surgery were collected.According to different surgical methods,patients were divided into experimental group(EG,n=39)who underwent thorough fiberboard decortication surgery and control group(CG,n=24)who underwent incomplete decortication surgery.Differences of operation time,operation bleeding,hospital stay and postoperative effects were compared.Results All patients recovered.The degree of lung recruitment,improvement of lung function and correction degree of thoracic morphology in EG were significantly improved.In CG,15 cases of residual cavity disappeared,and 9 cases of residual cavity were significantly reduced but not disappeared.There were significant differences between two groups in thoracic morphology recovery and respiratory function.Conclusion For patients with chronic calcified pleural empyema without lung damage,it is safe and feasible to perform thorough fiberboard decortication surgery.Implementing thorough fiberboard decortication surgery could significantly improve postoperative outcomes.