182例胸壁结核的外科治疗

目的 :提高胸壁结核的诊断正确率和手术治愈率。方法 :回顾分析我院 10年来手术治疗胸壁结核182例的经验教训 ,总结出诊断和鉴别诊断方法及治疗原则。结果 :手术治疗的 182例胸壁结核 ,术后 ,6例窦道形成 ,共 9例复发 ,均二次手术治愈 ,其余一期手术治愈。结论 :胸壁结核要与结核性脓胸所致胸壁穿通流注寒性脓肿、肋骨巨细胞瘤、肋软骨炎、等相鉴别 ,胸壁结核不能做一般的切开引流 ,手术前正规抗痨治疗 4～ 6周 ,手术要将病变组织彻底清除干净 ,脓腔大时术后还要放引流 ,术后需采取有效的加压包扎 3周左右 ,术后正规抗痨治疗 6～ 9个月以上

Surgical treatment of 182 thoracic wall tuberculosis

Objective: To improve final disgnosis rate and cure rate of thoracic wall tuberculosis.Methods: Reviewed 182 thoracic tuberculosis which had been operated in our hospital,and to sum up the differential diagnosis methods and therapeutic principle of thoracic tuberculosis.Results: 6 cases has sinus tract after focus debridement,9 cases relapsed and operated again,other cases have been cured at the first time.Conclusion: Differential diagnosis of thoracic wall tuberculosis is important,especially with tubercle encapsulated empyema,Giant cell tumor of lib,costal chondritis.In general,thoracic wall tuberculosis should not be only drainaged,but it can be drainaged if it has large abscess cavity after focus debridement,and it should be had anti tuberculosis treatment for 4 6 weeks before operation,binding up for 3 weeks after operation and continue anti tuberculosis treatment after operation for 6～9 monthes.