摘要
目的探讨结核性脓胸患者的胸腔镜辅助小切口手术效果。方法选取2011年5月~2016年1月我院收治的结核性脓胸患者94例,依据随机数表法分为观察组(胸腔镜辅助小切口手术)和对照组(传统开胸手术),每组47例,比较两组患者的术中术后情况、肺功能及术后并发症。结果观察组手术时间、术中出血量、胸管引流时间、引流量、止痛药使用时间及住院时间均明显低于对照组,差异具有统计学意义(P<0.05)。术前,两组患者的用力肺活量(FVC)、第一秒用力肺活量(FEV1)、最大呼气流速(PEF)和肺总量(TLC)均无显著差异(P>0.05)。术后,观察组患者的FVC、FEV1、PEF、TLC均明显高于对照组,差异具有统计学意义(P<0.05)。观察组47例,其中心律失常3例(6.38%),胸腔出血1例(2.13%),肺部感染1例(2.13%),总发生率为10.64%;对照组47例,其中心律失常6例(12.77%),胸腔出血3例(6.38%),胸肺漏气2例(4.26%),肺部感染4例(8.51%),切口感染3例(6.38%),总发生率为38.30%,两组并发症总发生率差异具有统计学意义(P<0.05)。结论胸腔镜辅助小切口手术治疗结核性脓胸成效显著,能够明显缩短手术时间及住院时间,改善患者肺功能,具有创伤性小、并发症少的优点。
Objective To investigate the effects of video-assisted minithoracotomy for patients with tuberculous empyema. Methods From May 2011 to January 2016,94 patients with tuberculous empyema were divided into the observation group which received video-assisted minithoracotomy and the control group which received the traditional thoracotomy,according to the random number table,with 47 cases for each. It was compared between the two groups in the peri-operative results,pulmonary functions and postoperative complications.Results Operation time,intraoperative blood loss,chest tube drainage time,drainage volume,analgesic duration and hospitalization stay of the observation group were significantly lower than that of the control group（P0.05）. There was no significant difference in the forced vital capacity（FVC）,first pass lung function（FEV1）,maximum expiratory flow rate（PEF） and total lung volume（TLC） between the two groups before operation（P0.05）. But after operation,it was significantly higher of FVC,FEV1,PEF and TLC in the observation group（P 0. 0 5）. There were 3 cases（6. 3 8 %） of arrhythm ia,1 case（2. 1 3 %） of thoracic hem orrhage,1 case（2. 1 3 %） of pulm onary infection in the observation group,with the total incidence rate of 10.64%. In the control group,there were 18 cases（38.30 %） of complications,including arrhythmia of 6（12.77%）,thoracic hemorrhage of 3（6. 38%）,chest lung leakage of 2（4. 26%）,pulmonary infection of 4（8. 51%） and incision infection of 3（6. 38%）. The difference of total complication rates between the two groups was statistically significant（P 0. 0 5）. Conclusions The video-assisted minithoracotomy is effective in the treatment of tuberculous empyema,which can significantly shorten operation time and hospitalization stay,improve the lung functions of the patients,with the advantages of less trauma and less complication.
作者
吴毓优
董吴平
王军
高炳玉
刘苏
WU Yu-you;DONG Wu- ping;WANG Jun;GAO Bing-yu;LIU Su(Department of Cardiothoracic Surgery, the First Affiliated Hospital of Hainan Medical College, Haikou 570102, Hainan, China)
出处
《中国现代手术学杂志》
2017年第4期305-308,共4页
Chinese Journal of Modern Operative Surgery
