单操作孔胸腔镜下胸膜纤维板剥脱术治疗慢性结核性脓胸的可行性分析*

Feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema*

摘要:

目的??探讨单操作孔胸腔镜下胸膜纤维板剥脱术治疗慢性结核性脓胸的可行性。方法 回顾性分析绍兴市立医院2013年1月-2016年5月微创治疗慢性结核性脓胸52例，其中50例在单操作孔胸腔镜下行胸膜纤维板剥脱术，2例改胸腔镜辅助小切口。结果 围手术期无死亡，手术时间60～240 min，平均160 min，术中出血150～2 000 ml，平均350 ml，术后放置胸管时间3～21 d，平均7 d，术后持续漏气3例，局限性肺不张3例，切口感染1例，胸腔渗血1例，心律失常3例，均经过相应治疗后痊愈。失访3例，其余49例随访3～36个月，肺复张良好，效果满意。结论 严格选择适应证的条件下单操作孔胸腔镜下胸膜纤维板剥脱术治疗慢性结核性脓胸安全可行，值得应用推广。

Abstract:

Objective?To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema.?Methods?Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases.?Results?There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2 000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis.?Conclusion?Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.