新发传染病电子杂志2023，Vol.8Issue(6)：27-30,4.DOI:10.19871/j.cnki.xfcrbzz.2023.06.005
单孔胸腔镜胸膜纤维板剥脱治疗Ⅲ期结核性脓胸临床疗效
Clinical effect of uniportal thoracoscopic decortication for stage Ⅲ tuberculous empyema
摘要
Abstract
Objective To explore the safety and feasibility of uniportal thoracoscopic decortication in the treatment of stage Ⅲ tuberculous empyema.Method From June 2020 to June 2022,52 patients including 38 males and 14 females with stage Ⅲ tuberculous empyema who underwent uniportal thoracoscopic decortication were retrospectively analyzed in Department of Thoracic Surgery,The Third People's Hospital of Shenzhen.The mean age was(36.96±14.24)years(range:21 to 72 years).general After general anesthesia,a 4-5cm incision was made in the center of the pus cavity.In the case of severe intercostal stenosis,a section of rib was removed.And the outer parietal pleural space was separated.With the help of incision protector the thickened visceral parietal pleural fibreboard was removed free under a single hole.Follow-up was performed in the outpatient clinic monthly.When there is no air leakage in the thoracic drainage tube,the color of the drainage fluid is pale,and the drainage volume is less than 100ml/d,the chest tube was removed.If chest imaging showed good lung dilation,the drainage volume of the trench drainage tube was＜50ml/d,the trench drainage tube was removed,and the anti-tuberculosis treatment plan was formulated according to the bacteriological examination results.The postoperative follow-up was 12 months.The postoperative imagings were performed at 6 and 12 months.and compared with preoperative chest CT.Result Among the 52 cases,27 cases had excellent recovery,21 cases had good recovery and 4 cases general recovery.The excellent and good rate of postoperative cure was 92.3%,No patients had recurrence.Among the 52 patients,51 cases underwent uniportal thoracoscopic decortications,and 1 case changed to thoracotomy.The operative time was(268±110)min(range:110 to 430)min;and median blood loss was(126±68)ml(range:50 to 300 ml).All patients were discharged with 2 chest tubes,and the median duration drainage was(5±2.5)days(range:3 to 16 days),and(9.0±2.8)days(range:7 to 21 days)separately.The postoperative hospital stay was(5.0±2.5)days(range:3 to 7 days).There were no major complications except 1 case of prolonged lung leakage with the thoracic tube was removed 16 days after surgery,2 cases of incision infection and 1 case encapsulated pleural effusion.Conclusion Uniportal thoracoscopic decortication is safe,feasible and effective for patients with stage Ⅲ tuberculous empyema.关键词
脓胸,结核性/纤维板剥脱术/胸腔镜Key words
Empyema,tuberculous/Decortication/Thoracoscopic分类
医药卫生引用本文复制引用
王海江,乔坤,郑硕,王延锋,黄丕来,施琴朗,宁新忠,付强,夏照华,陶筱婷..单孔胸腔镜胸膜纤维板剥脱治疗Ⅲ期结核性脓胸临床疗效[J].新发传染病电子杂志,2023,8(6):27-30,4.基金项目
1.深圳市科技创新委员会(JSGG20210901145200001,JCYJ20210324130601005) （JSGG20210901145200001,JCYJ20210324130601005）
2.深圳市高水平医院建设专项经费(深圳市第三人民医院院级课题编号G2022042,G2022123) （深圳市第三人民医院院级课题编号G2022042,G2022123）
