217例空洞性肺结核的外科治疗

目的探讨空洞性肺结核的外科治疗适应症,手术方法,术后管理。方法自2000年1月～2009年12月,外科治疗217例空洞性肺结核,其中厚壁空洞73例,薄壁空洞34例,张力空洞26例,慢性空洞127例。痰菌阳性94例,78例均有不同程度耐药。结果择期手术191例,大咯血急症手术26例。空洞清除18例,肺段切除27例,肺叶切除44例,上叶加下叶背段切除34例,上叶加下叶背段病灶清除21例,中下叶切除20例,中上叶切除14例,右全肺切除12例,左全肺切除23例。全组无手术死亡,6例复发,4例术后合并脓胸,4例合并支气管胸膜瘘,5例合并支气管残端瘘,其余全部病例无复发,治愈率97.1%。痰菌阴转率93.6%。讨论外科手术是空洞性肺结核内科治疗失败者较有效的手段。手术原则为宁小勿大,以肺叶切除方式为主。

Surgical operation in the treatment of 217 cases of pulmonary tuberculosis with cavitation

Objective To discuss the indication and methods of surgical operation in the treatment of pulmonary cavitary tuberculosis.Methods 217 operated cases of pulmonary cavitary tuberculosis have been reviewed,including 73 cases of thick-walled cavity,34 cases of thin-walled cavity,26 cases of tensional cavity,127 cases of Chronic cavity,94 cases of sputum positive,78 cases of drug resistance.Results 191 cases of selective surgery,26 cases of massive hemoptysis emergency operation.18 cases of cleaning cavity opera...