胸腔镜介导下微波和钳夹治疗多房性结核性胸腔积液

目的评价内科胸腔镜介导下微波和钳夹治疗多房性结核性胸腔积液的疗效和安全性。方法将60例多房性结核性胸腔积液患者随机分为3组,在正规抗结核治疗的基础上,A组采用内科胸腔镜介导下微波和钳夹治疗,B组胸腔内注入尿激酶治疗,C组为常规胸腔穿刺抽液,比较三组抽液效果、临床疗效、胸膜肥厚、肺功能的影响及不良反应。结果A组抽液效果明显优于B、C两组,临床疗效和对胸膜肥厚、肺功能的影响明显好于C组（P〈0.05）,与B组差异无显著性（P〉0.05）,未见严重并发症。结论内科胸腔镜介导下微波和钳夹治疗为多房性结核性胸腔积液提供了一种新的辅助治疗手段,具有疗效好,胸水吸收快,操作简单、安全,并发症少、患者恢复快等优点。

Forceps Holder and Microwave Treatment Guided by Thoracoscopy for Multilocular Tuberculous Pleural Effusion

Objective To assess the security and clinical effect of forceps holder and microwave guided by thoracoscopy for patients with tuberculous multilocular pleural effusion. Methods Sixty patients with tuberculous multilocular pleural effusion were recruited and randomly divided into three groups. On the basis of conventional anti tuberculousis treatment, group A was treated by forceps holder and microwave guided by medical electron-assisted thoracoscopy, group B was injected with urokinase in thorax, group C received routine thoracentesis and hydrothorax abstraction. The drainage quantity, clinical effect, the thickness of pleura, pulmonary function and complication were compared. Results The drainage quantity in group A was significantly more than those in group B and C. The clinical effect, the thickness of pleura and pulmonary function in group A were improved than group C （P〈0. 05）, but not significantly different from group B （P〉0. 05）. No serious complication was found in three groups. Conclusion The assistant therapy of forceps holder and microwave guided by medical electron-assisted thoracoscopy is very effective and reliable in treating tuberculous multiloeular pleural effusion. The absorption of pleural effusion is fast, the operation is easy.and patients have no serious complication and recover soon.