小切口开胸病灶清除术治疗空洞型肺结核和肺结核球(附18例报告)

Mini-thoracotomy focus cleaning for cavitary pulmonary tuberculosis or pulmonary tuberculoma: A report of 18 cases

目的 探讨病灶清除术治疗空洞型肺结核和肺结核球的效果和可行性。 方法 胸部小切口入路治疗长期抗痨后或复治的空洞型肺结核和肺结核球。慢性纤维空洞型肺结核行空洞病灶清除术 8例 ,肺结核球单纯病灶清除术 1 0例 ,病灶清除后对遗留残腔进行冲洗和折叠缝合。 结果 1 8例全部临床治愈 ,痰菌转阴 ,肺部阴影消失 ,无手术并发症。全组随访 1年～ 4年 ,未见复发。 结论 病灶清除术是一种有效的外科治疗肺结核的方法 ,这种方法减少对机体的创伤 ,最大限度地保留病人的肺功能 。

Objective To investigate the effects and feasibility of mini-thoracotomy focus cleaning in the management of cavitary pulmonary tuberculosis or pulmonary tuberculoma. Methods The mini-thoracotomy approach was adopted in patients with cavitary pulmonary tuberculosis or pulmonary tuberculoma who had undergone long-term anti-tuberculosis therapy or needed a re-treatment.Eight patients with chronic fibro-cavitative pulmonary tuberculosis and 10 patients with pulmonary tuberculoma underwent focus cleaning, irrigation, and folding suture. Results All the 18 patients were cured clinically, with their sputum findings turning negative for bacteria and pulmonary shadows subsiding. No operative complications occurred. Follow-up for 1～4 years found no recurrence. Conclusions Focus cleaning is an effective surgical alternative for pulmonary tuberculosis after proper selection of cases. The procedure is minimally invasive and patient's pulmonary function can be protected to the greatest possible advantage.