摘要
目的探讨电视胸腔镜治疗肺结核的临床应用价值及评价临床疗效。方法回顾新疆维吾尔自治区胸科医院胸外中心2009年9月-2017年1月使用胸腔镜手术治疗的肺结核患者523例,将523例分为3组,A组179例(34.2%)实施肺叶、肺段或全肺切除术;B组213例(40.7%)实施肺楔形切除术;C组131例(25.1%)实施胸膜剥脱术,三组病例均在完全胸腔镜下完成。结果523例均在全胸腔镜下完成手术,A组中实施肺叶切除术168例(93.9%,168/179),肺段切除术8例(4.5%,8/179),全肺切除术3例(1.6%。3/179);B组213例(100.0%,213/213)均实施肺楔形切除术;C组131例(100.0%,131/131)均实施胸膜剥脱术,围手术期并发症共计19例,占3.6%(19/523),A组13例,占7.3%(13/179),B组4例,占1.9%(4/213),C组2例,占1.5%(2/131),无死亡病例。结论VATS治疗肺结核应严格掌握手术适应症,在规范的术前、术后抗结核用药的基础上进行,只要熟练掌握VATS操作技术,是可以应用到肺结核的治疗中,肺结核患者往往体质较弱,免疫力较差,胸部微创手术可以减少患者的创伤应激。
Objective To evaluate the value and safety of applying thoracoscopy in pulmonary tuberculosis patients, and analyze clinically about 523 PTB patients who received thoracoscopy surgery. Methods 523 patients with pulmonary tuberculosis undergoing thoracoscopic surgery in the Center of Thoracic Surgery of our hospital between February 2009 and December 2016 were selected. Results There were 523 patients undergoing thoraeoseopic surgery. Among them, 179 cases （34.2%） underwent lobectomy, lung segmentation or to pneumonectomy. 213 （40.7%） patients underwent wedge resection of the lungs. 131 （25.1%） patients underwent pleural deeortication. 13 （7.3%, 13/179） patients got lobectomy, lung segmentation or pneumonectomy with complications. 4 （ 1.9%, 4/213） patients had compfications of wedge resection of lung. 2 （1.5%, 2/131） patients were having pleural deeortication complications. Conclusion Video-assisted thoracoseopic surgery （VATS） is therapeutically useful and feasible for selected patients with pulmonary TB.
出处
《新疆医学》
2017年第6期585-588,共4页
Xinjiang Medical Journal
基金
国家卫生计生委医药卫生科技发展研究中心项目(w2014RQ21)
关键词
肺结核
胸腔镜
肺叶切除术
肺切除术
Pulmonary luberculosis
Thoracoscopes
Pneumonectomy
Lobectomy
