腹腔镜外科杂志2024，Vol.29Issue(11)：810-814,824,6.DOI:10.13499/j.cnki.fqjwkzz.2024.11.810
不同时机行单孔胸腔镜胸膜纤维板剥脱术治疗慢性结核性脓胸的效果及预后分析
The effect and prognosis analysis of single-port thoracoscopic pleural fibreboard stripping for the treatment of chronic tuberculous empyema at different timing
摘要
Abstract
Objective:To investigate the effect and prognosis of single-port thoracoscopic pleural fibreboard stripping for the treatment of chronic tuberculous empyema at different timing.Methods:Patients with chronic tuberculous empyema from Apr.2020 to May 2022 were retrospectively selected as the research subjects,all of whom underwent single-port thoracoscopic pleural fibreboard stripping.They were divided into two groups according to different surgical timing,the early group received surgery at 6-12 weeks after anti-tuberculosis treatment,while the conventional group received surgery after 12 weeks of anti-tuberculosis treatment.The clinical effi-cacy,perioperative indicators,and complications of the two groups were compared,as well as the pulmonary function indicators and qua-lity of life before and after surgery.Results:The total clinical effective rate of the early group was91.18%,which was higher than that of the control group(76.47%,P<0.05).The early group had less intraoperative blood loss and postoperative drainage volume at 24 h than the conventional group,and the thickness of pleural fibreboard was fewer than that of the conventional group.The operation time,postoperative tube-carrying time,and postoperative hospitalization time of the early group were shorter than those of the conventional group(P<0.05).The forced vital capacity,forced expiratory volume in one second,forced expiratory volume in one second/forced vital capacity,and peak expiratory flow in both groups increased at 4 d after the removal of chest closed drainage tubes and 3 months after surgery compared with before surgery,and the early group was higher than the conventional group(P<0.05).The scores of physical health,psychological function,social relationship,and surrounding environment in both groups three months after surgery were higher than those before surgery,and the early group was higher than the conventional group(P<0.05).The incidence of postoperative com-plications in the early group was7.35%,which was lower than that in the conventional group(23.53%,P<0.05).Conclusions:Early(at 6 to 12 weeks of anti-tuberculosis treatment)single-port thoracoscopic surgery for chronic tuberculous empyema can enhance the therapeutic effect,reduce intraoperative blood loss and postoperative drainage,shorten the operation time and postoperative recovery process,significantly improve lung function and quality of life,and reduce the incidence of complications.关键词
脓胸,结核性/胸膜纤维板剥脱术/胸腔镜检查/单孔/治疗结果/预后Key words
Empyema,tuberculous/Pleural fibreboard stripping/Thoracoscopy/Single-port/Treatment outcome/Prognosis分类
医药卫生引用本文复制引用
何超..不同时机行单孔胸腔镜胸膜纤维板剥脱术治疗慢性结核性脓胸的效果及预后分析[J].腹腔镜外科杂志,2024,29(11):810-814,824,6.基金项目
湖南省卫生健康委科研项目(S2021JJKWLH0344) （S2021JJKWLH0344）
