胸膜纤维板剥脱术治疗慢性脓胸临床分析

Clinical analysis of pleural fibreboard stripping operation in the treatment of chronic empyema

目的:探讨脏层胸膜纤维板剥脱术治疗慢性脓胸的效果。方法:将62例慢性脓胸患者随机分为治疗组和对照组,各31例。治疗组行全麻下脏层胸膜纤维板剥脱术,部分病例加做肺切除。对照组行脏层、壁层胸膜纤维板同时剥脱。观察手术治疗效果及术后恢复情况、并发症等。结果:治疗组切口感染1例,其余均治愈出院,平均手术时间1.5 h,输血310 m L,引流管拔除时间3.1 d,住院天数12.3 d。对照组4例因术后呼吸衰竭行1~3 d机械通气支持,术后合并多器官功能障碍死亡1例,切口感染4例,平均手术时间2.5 h,输血630 m L,引流管拔除时间5.3 d,住院天数16.7 d。结论:脏层胸膜纤维板剥脱术治疗慢性脓胸并发症少,恢复快,疗效满意。

Objective:To explore the effect of visceral layer pleural fibreboard stripping operation in the treatment of chronic empyema.Methods:62 patients with chronic empyema were randomly divided into the treatment group and the control group with 31 cases in each.The treatment group was given visceral layer pleural fibreboard stripping operation under general anesthesia, some cases added do pneumonectomy.The control group was given visceral layer and parietal layer pleural fibreboard and desquamation.The surgical treatment effect,postoperative recovery and complications were compared.Results:The treatment group had 1 case of incision infection;the others were cured;the average operation time was 1.5 hours;the blood transfusion was 310 mL;the drainage tube removal time was 3.1 days;the hospitalization time was 12.3 days.In the control group,4 cases of postoperative respiratory failure were given 1 to 3 days mechanical ventilation support;1 case of postoperative combined multiple organ dysfunction was died;4 cases were incision infection;the average operation time was 2.5 hours;the blood transfusion was 630 mL;the drainage tube removal time was 5.3 days;the hospitalization time was 16.7 days.Conclusion:The pleural fibreboard stripping operation in the treatment of chronic empyema has few complications,quick recovery,satisfied curative effect.