摘要
目的观察电刀锐性分离在胸膜纤维板剥脱术中的应用价值。方法选取2012年8月-2015年2月河北省胸科医院胸外科需要手术治疗的慢性结核性脓胸患者92例,采用电脑随机数字表法分为2组,治疗组及对照组各46例,治疗组采用电刀锐性分离行胸膜纤维板剥脱术,对照组采用传统胸膜纤维板剥脱术,记录手术时间、术中失血量、术后24 h引流量、带管时间、输血量以及术后液气胸发生率、胸腔内出血发生率、切口液化感染率,并进行组间比较。结果 2组手术时间比较差异无统计学意义[(253.59±71.64)min vs.(255.11±68.02)min,t=-0.104,P>0.05];治疗组术中失血量为(163.37±104.03)ml,术后24 h引流量为(285.37±84.57)ml、带管时间为(7.91±2.79)d、输血量为(115.22±168.61)ml,对照组分别为(611.30±184.25)ml、(502.17±173.76)ml、(10.24±3.75)d、(602.17±268.73)ml,2组比较差异均有统计学意义(t=-14.358、-7.609、-3.377、-10.066,P<0.01);治疗组术后无液气胸、胸腔内出血发生,对照组液气胸、胸腔内出血发生率为17.39%、13.04%,2组比较差异有统计学意义(X^2=8.762、6.419,P<0.05);治疗组切口液化感染率与对照组比较,差异无统计学意义(8.70%vs.13.04%,X^2=0.449,P>0.05)。结论电刀锐性分离行胸膜纤维板剥脱术可以减少术中失血量、减少术后24 h引流量、缩短带管时间、减少输注血液制品量、降低术后液气胸发生率和胸腔内出血发生率,具有推广应用价值。
Objective To investigate the role of electric knife sharp separation in decortication treatment for patients with chronic tuberculous empyema .Methods From August 2012 to February 2015, 92 cases of stage III of chronic tubercu-lous empyema were randomly divided into two groups in Hebei Chest Hospital .The experimental group had 46 cases and con-trol group had 46 cases.In experimental group , patients were treated with decortication by using electric knife sharply separa-ted the fiber board, in control group, traditional decortication was performed .The operation time, intraoperative blood loss, drainage quantity after 24 h postoperatively , intubation time , the amount of blood transfusion , and the incidence of postopera-tive hydro-pneumothorax , the incidence of postoperative bleeding and the incidence of liquefaction of the subcutaneous fat and wound infection were compared between the two groups .Results The experimental group and the control group ’ s average op-eration time were （253.59 ±71.64） min and （255.11 ±68.02） min,there was no statistically difference between the two groups（ P 〉0.05）.The intraoperative blood loss, drainage quantity after 24h postoperatively, intubation time,the amount of blood transfusion of experimental group [（163.37 ±104.03） ml, （285.37 ±84.57） ml,（7.91 ±2.79 ） d, （115.22 ± 168.61）ml] were significantly decreased compared to control [（611.30 ±184.25）ml, （502.17 ±173.76）ml, （10.24 ± 3.75） d, （602.17 ±268.73）ml, t =-14.358,-7.609,-3.377,-10.066, P 〈0.01],incidence of postoperative hydro-pneumothorax and incidence of postoperative bleeding of control group （17.39%, 13.04%） was higher than experimental group （P 〈0.05）.The incidence of liquefaction of the subcutaneous fat and wound infection were 8.70% and 13.04%（P 〈0.05）.Conclusion Electric knife sharp separation for decortication can reduce intraoperative blood loss , postoperative 24 h after drainage and shorten the intubation time , reduce the amount of bl
出处
《疑难病杂志》
CAS
2017年第1期48-51,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
结核性脓胸
慢性
胸膜纤维板剥脱术
手术
Tuberculous empyema,chronic
Decortication
Surgical treatment
