肌瓣填充术治疗慢性脓胸

Muscle-flaps Graft in the Surgical Treatment of Chronic Empyema

慢性脓胸的治疗基本原则是消除感染和消灭脓腔。胸腔切开引流术仅可促进消除感染,而消灭脓腔则需采用以下两类手术:①胸廓成形术:如胸膜外胸廓成形术,Schede胸膜内胸廓成形术,Heller胸膜内胸廓成形术,及由此发展的肌瓣填充术;②胸膜纤维层剥脱术;各手术均有优缺点,须按具体情况选用或合用。胸膜外胸廓成形术往往达不到彻底消灭残腔的目的。Schede手术破坏性很大,愈合后畸形特别严重,早已弃用。

Muscle-flap graft has been used as an adjunct to intrathoracic thoracoplasty for the treatment of chronic empyema in 30 patients with satisfactory results.By the use of muscle grafts, complete obliteration of the residual space left behind, after removal of the corresponding ribs as well as the fibrous plate closely attached to the parietal pleura could be obtained.The use of the muscle grafts and its surgical techniques have been carried out on the basis of anatomical studies of 30 cadavers on 30 pairs of specimens, The conclusions that the latissimus dorsi, serratus anterior, and other muscles may be utilized.The important points regarding the surgical technique have been briefly discussed.