胸部小切口病灶清除术治疗外穿性脓胸的临床效果

目的 探讨胸部小切口病灶清除术治疗外穿性脓胸的临床效果.方法 选取2011年1月—2016年1月河北省胸科医院外穿性脓胸患者67例,采用胸部小切口病灶清除术的36例为观察组,采用传统手术的31例为对照组.观察两组治疗效果、切口长度、术中出血量、术后疼痛评分、手术时间、术后引流量、置引流管时间、术后住院时间、术后并发症发生率.结果 两组手术均顺利完成,术后第1天复查胸片显示脓腔消失,涨肺良好.观察组切口长度、术中出血量、术后疼痛评分、术后引流量、置引流管时间、住院时间均少于对照组(P<0.05).观察组手术时间与对照组比较差异无统计学意义(P>0.05).两组并发症发生率比较差异无统计学意义(P>0.05).结论 在严格掌握适应证及充分术前评估基础上,胸部小切口病灶清除术治疗外穿性脓胸具有切口小、术中出血及术后引流量少、术后疼痛评分低及住院时间短等特点.

Clinical Efficacy of Focal Cleaning with Minimal Incision of Thoracotomy in Treatment of Empyema necessitatis

Objective To investigate clinical efficacy of focal cleaning with minimal incision of thoracotomy in treatment of empyema necessitates. Methods A total of 67 patients with empyema necessitates during January 2011 and January 2016 were divided into observation group (n=36), who were treated with focal cleaning with minimal incision of thoracotomy, and control group (n=31) who were treated with traditional operation. Efficacy, incision length, intraoper-ative bleeding volume, postoperative pain score, operative duration, postoperative draining volume, laying time of drain-age tube, postoperative hospital stay and incidence rate of complications were observed in two groups. Results All oper-ations were completed successfully in both groups. At the 1st d after surgery, the chest X-ray showed that the abscess cav-ity disappeared, and the lung recruitment was good. Values of incision length, intraoperative bleeding volume, postopera-tive pain score, postoperative draining volume, laying time of drainage tube and hospital stay in observation group were lower than those in control group (P<0. 05). There were no significant differences in operative duration and incidence rate of complications in two groups (P>0. 05). Conclusion On the basis of enough understanding indications and per-forming preoperative evaluation, focal cleaning with minimal incision of thoracotomy in treatment of empyema necessitates has the advantages such as shorter incision length, less bleeding volume and postoperative draining volume, lower postop-erative pain score and shorter postoperative hospital stay.