摘要
目的分析上海市肺科医院7年来经电视胸腔镜行肺切除术治疗肺结核患者的经验。方法收集上海市肺科医院自2009年1月1日至2016年1月1日通过胸腔镜手术完整切除肺部病灶、最后被证实为肺结核的患者815例。其中111例患者术前明确诊断为肺结核，并经过正规抗结核药物治疗而不能耐受或者治疗效果不佳的局限性病灶；其余704例患者为以孤立性肺结节为表现，术前怀疑恶性肿瘤而进行手术。所有患者术后由结核内科医师制定抗结核药物治疗方案，让患者坚持服药，并且进行随访，随访时间11～60个月，平均（32±14）个月。结果肺叶切除术383例，楔形切除术326例，肺段切除术86例，扩大肺叶切除术20例。所有患者无围术期死亡；54例患者（6．6％）中转开胸；近期发生主要并发症包括持续性肺瘘、余肺感染、支气管胸膜瘘、肺动脉栓塞，以及剖胸止血共65例，并发症发生率为8．0％；798例患者在随访期间无复发，治愈率为97．9％（798／815）。结论胸腔镜肺切除术治疗肺结核是一个安全有效的方法。
Objective To analyze the experience of the treatment of patients with pulmonary tuberculosis by video-assisted thoraeoscopic surgery （VATS） in Shanghai Pulmonary Hospital in seven years. Methods Eight hundred and fifteen cases with pulmonary tuberculosis confirmed diagnosis underwent lesion resection by VATS including preoperative diagnosis pulmonary tuberculosis and regular antituberculosis due to intolerance or poor response in 111 cases and solitary pulmonary nodule suspected malignant tumor in the other 704 cases in Shanghai Pulmonary Hospital during Jan. 1, 2009 to Jan. 1, 2016. All patients insisted on antituberculosis with regular regimen designed by physician and follow up for average （32 ± 14） months ranged from 11 to 60 months. Results There were pulmonary lobectomy in 383 cases, wedge resection in 326 cases, segmentectomy in 86 cases and extended lobectomy in 20 cases. No perioperative death occurred in all patients. 54 cases （6.6%） were conver ted to thoracotomy. Early complications including pulmonary fistula, pulmonary infection, bronchopleural fistula, pulmonary embolism, thoracotomy for hemotasis occurred in 65 cases （8.0%）. No relapse case was found among 798 cases during the follow-up. The cure rate was 97.9% （798/815）. Conclusion VATS is a safe and effective method for the treatment of pulmonary tuberculosis.
出处
《中国防痨杂志》
CAS
2017年第5期448-451,共4页
Chinese Journal of Antituberculosis
关键词
结核
肺
胸腔镜
胸外科手术
电视辅助
肺切除术
治疗结果
Tuberculosis, pulmonary
Thoracoscopes
Thoracic surgery, video-assisted
Lung resec-tion
Treatment outcome
