单侧肺全切除术治疗单侧结核性全肺毁损48例分析

目的总结结核性单侧全肺毁损的外科治疗经验。 方法对48单侧结核性全肺毁损患者行全肺切除术，回顾性分析临床资料。结果48例中胸膜外全肺切除36例，术中出血500～5300ml，术后近期并发症12例（25%）：急性肺水肿3例，呼吸衰竭4例，脓胸3例，纵隔摆动2例，远期并发症为1例（2.1%）缩窄性心包炎；治愈45例（93.8%）；死亡2例（4.2%）。结论对单侧结核性全肺毁损患者，如果持续排菌或有明显症状，其心肺功能能代偿，应积极进行手术治疗，效果较满意。

Analysis on surgical treatment in 48 patients with unilateral tuberculous destroyed lung

Objective To summarize the experience of surgical treatment for unilateral tuberculous destroyed lung. Methods Forty-eight patients with unilateral tuberculous destroyed lung were treated by pneumonectomy,and the clinical data was analyzed retrospectively. Results Pneumonectomies in 48 cases were successful, and pleuropneumonectomies in 36 cases were performed. The peri-operative bleeding amount ranged from 500 ml to 5 300 ml. Postoperative short-term complications occured in 12 cases（25 %）,including 3 acute pulmonary oedema,4 respiratory failure, 3 empyema,and 2 mediastinal flutter. Postoperative long-term complication was constrictive periearditis in 1 case （2.1%）. Forty-five cases were cured（93.8%）, 2 cases died（4. 2%）. Conclusion The patients with unilateral tuberculous destroyed lung whose medical therapy is failed should be performed surgical treatment if their cardio-pulmonary function are compensative. The rate of complication and mortality are acceptable.