86例胸壁结核外科治疗的体会

目的 探讨胸壁结核的外科治疗方法.方法 回顾性分析从1990年10月～2006年6月手术治疗的86例患者的临床资料.结果 患者86例,年龄14～70岁,男52例,女34例,有结核病史者16例,21例患者合并有肺结核.所有患者在手术前后均接受了抗结核药物治疗,86例患者中12例进行了胸壁结核脓肿切除,肋骨切除加肌瓣填塞72例,胸廓成形术2例,全部患者随访1～5年无复发.结论 胸壁结核脓肿病灶的广泛切除和手术前后抗结核治疗,是防止复发的关键.

Surgical treatment of tuberculous abscess in the chest wall

Objective To explore the surgical treatment of tuberculous abscess in the chest wall.Methods The records of 86 pa- tients who underwent surgical treatment of tuberculous abscess in the chest wall were retrospectively reviewed between October 1990 to June 2006 in our hospital.Results Their ages ranged from 14 to 70 years,the male to female ratio was 1.5:1(male 52,fe- male 34).There was a past history of tuberculosis in 16 patients,concomitant active pulmonary tuberculosis in 21.In all patients, preoperative and postoperative antituberculous treatments were administered.All of the patients underwent surgical treatment,12 patients underwent excision of chest wall abscesses,72 patients underwent chest wall and rib resection with muscle flap,2 patients with thoracoplasty.All patients were followed up from 1 to 5 years,and there was no recurrence.Conclusion In managing tubercu- lous abscess of the chest wall,extensive abscess excision with rib resection is considered to be important,perioperative anti-tubercu- losis medication may play an important role in reducing the postoperative recurrence.