电视胸腔镜下脓胸清除术治疗慢性结核性脓胸的临床疗效

目的 探讨慢性结核性脓胸传统开放手术与电视胸腔镜手术的临床疗效。方法 选择2012年1 月至2017 年12月安徽省胸科医院胸外科行手术治疗的43例慢性结核性脓胸患者，按照手术方式将患者分为对照组（21例）与观察组（22例），对照组行常规开胸手术治疗，观察组采取电视胸腔镜手术治疗。比较两组患者近期和远期的手术疗效。结果 观察组患者术中出血量为（220.72±32.25）mL、术后3 d引流量为（693.43±52.64） mL、引流管放置时间为（5.12±1.43）d、住院时间为（12.41±2.32）d，均低于对照组，差异有统计学意义（P<0.05）。两组患者术后1年的肺活量、第1秒肺活量、肺总量均高于术前，差异有统计学意义（P<0.05）；两组患者治疗前、治疗后的肺功能恢复指标及差值比较，差异无统计学意义（P>0.05）。结论 慢性结核性脓胸行电视胸腔镜手术治疗安全可行，值得临床推广应用。

The clinical effect of thoracoscopic surgery for thoracic empyema removal in treatment of chronic tuberculous empyema

Objective To investigate the clinical effect of traditional open surgery and video-assisted thoracoscopic surgery for removal of chronic tuberculous empyema. Methods The clinical data of 43 patients with chronic tuberculous empyema treated by thoracic surgery were retrospectively analyzed in Anhui Chest Hospital from January 2012 to December 2017. Among them, 22 patients with video-assisted thoracoscopic surgery were set as the observation group and 21 patients with open surgery as the control group. The short-term and long-term surgical outcomes of the two groups were compared. Results Compared with control group, the intraoperative blood loss (220.72±32.25)mL, 3d postoperative drainage volume(693.43±52.64) mL, drainage tube placement duration(5.12±1.43)d,and length of hospital stay(12.41±2.32)d in observation group decreased significantly, and 1 year of postoperative follow-up showed a good recovery of lung function. Conclusions Video-assisted thoracoscopic surgery for treatment of chronic tuberculous empyema is safe and feasible, which is worth clinical application.