胸腔镜在非结核性脓胸治疗中的应用

目的探讨胸腔镜在非结核性脓胸治疗中的应用、方法32例脓胸患者经病史、胸片、CT及B超检查或穿刺确诊，在胸腔镜辅助下进行胸膜剥离手术，术后进行随访：结果32例行胸腔镜手术患者中，5例加小切口手术，9例改行常规开胸手术，平均手术时间1．8h，胸腔引流2～21d，引流量300—2000mL，经随访，肺功能恢复良好，无一例脓胸复发，无术后并发症。结论胸腔镜手术治疗纤维素性脓胸可有良好效果，机化初期脓胸用胸腔镜加小切口手术可减少创伤，机化晚期脓胸需行常规开胸手术。

Application of video-assisted thoracoscopy in treatment of nontuberculous pleural empyema

Objective To discuss application of video-assisted thoracoscopic surgery in the management of nontu-berculous pleural empyema. Methods Thirty-two patients suffered from nontuberculous pleural empyema were diagnosed by history, X-ray, chest computed tomography and ultrasonography and treated by debridement using of video-assisted thoracoscopic (VATS). All patients were followed up. Results Among 32 patients treated by video-assisted thoracoscopic, 5 were added the mini-incision and 9 were turned to operation by standard thoracotomy. The mean operative time was 1.8 h. There were no complications during video-assisted thoracic operations. The mean duration of postoperative chest tube drainage was 7 d. Drainage volume was 300 - 2 000 mL. At follow-up with pulmonary function tests, all patients showed normal values. No recurrence of empyema was observed. Conclusion Debridement using video-assisted thoracoscopic represents a suitable treatment for fibrinopurulent empyema. In an early organizing phase, indication for video-assisted thoracic operation should be considered in due time to ensure a definitive therapy with a minimally invasion. For pleural empyema in a later organizing phase, routine thoracotomy with decortication remains the treatment of choice.