内科胸腔镜下胸腔内清理治疗非结核性脓胸的临床研究

Thoracoscopy in treatment of non tuberculous empyema

摘要:

观察分析胸腔镜下胸腔内清理治疗非结核性脓胸的临床疗效。方法  选取2015年1月-2017年6月于该院就诊的非结核性脓胸患者48例，根据治疗方式，分为观察组（n =24）与对照组（n =24），观察组患者给予胸腔镜下胸腔内清理治疗，对照组患者给予传统开胸术治疗，对比两组患者的治疗效果。结果  观察组患者的手术时间、术中出血量、引流时间、住院时间均明显少于对照组（P <0.05）；治疗前，两组患者的用力肺活量（FVC）、第一秒用力肺活量（FEV1）、肺总量（TLC）对比差异无统计学意义（P >0.05）；治疗后，两组患者的FVC、FEV1、TLC均明显增加（P <0.05），且观察组患者的FVC、FEV1、TLC明显高于对照组（P <0.05）。两组患者治疗后氧分压（PO2）、二氧化碳分压（PCO2）及白细胞计数（WBC）明显优于治疗前，且观察组治疗后患者PO2（80.30±9.26）mmHg、PCO2（45.53±4.27）mmHg及WBC（8.85±
3.62）g/L指标明显优于对照组的PO2（70.33±8.75）mmHg、PCO2（51.61±5.40）mmHg及WBC（10.81±
4.00）g/L，差异有统计学意义（P <0.05）。结论  胸腔镜辅助下行胸腔内清理治疗非结核性脓胸的创伤小，术后患者恢复快。

Abstract:

Abstract: Objective To observe the clinical efficacy of thoracoscopic pleural dissection in the treatment of non tuberculous empyema. Methods 48 non tuberculous empyema were selected from January 2015 to June 2017, according to the treatment methods, divided into the observation group (n = 24) and control group (n = 24), the observation group was treated with thoracoscopic pleural dissection treatment, the control group were treated with traditional thoracotomy for the treatment of more than two groups, effect of treatment. Results The observation group of patients with operation time, bleeding volume, drainage time and hospitalization time were significantly less than the control group (P < 0.05); the two groups of patients before treatment, FVC, FEV1, TLC compared no significant difference, no statistical significance (P > 0.05); after treatment, the patients' FVC, FEV1, TLC significantly increased (P < 0.05), and the patients in the observation group FVC, FEV1 and TLC were significantly higher than that of the control group (P < 0.05). PO2, PCO2 and WBC were significantly better than the treatment of two groups of patients after treatment, and the observation group of patients with PO2 after treatment (80.30 ± 9.26) mmHg, PCO2 (45.53 ± 4.27) mmHg and WBC (8.85 ± 3.62) g/L index was significantly better than the control group PO2 (70.33 ± 8.75) mmHg, PCO2 (51.61 ± 5.40) mmHg and WBC (10.81 ± 4.00) g/L, the difference was statistically significant (P < 0.05). Conclusion Video-assisted thoracoscopic surgery for the treatment of non tuberculous empyema has less trauma and faster postoperative recovery.