胸腔镜下胸膜固定术治疗晚期肺癌恶性胸腔积液临床分析

目的：比较胸腔镜下滑石粉胸膜固定术与常规胸腔闭式引流后于胸腔内灌注滑石粉两种方法治疗晚期肺癌恶性胸腔积液的临床疗效。方法选择2014年1月—2016年9月我院收治的晚期肺癌恶性胸腔积液患者31例为观察组，2011年1月—2013年12月收治的晚期肺癌恶性胸腔积液患者33例为对照组。观察组行胸腔镜下滑石粉胸膜固定术，对照组采用常规的胸腔闭式引流后于胸腔内灌注滑石粉。比较2组患者术后引流管留置时间、住院时间、近期并发症发生情况及胸水控制情况。结果术后12周，观察组完全缓解率90.3%，有效率96.8%，对照组完全缓解率33.3%，有效率63.6%，差异均有统计学意义（P<0.05）；观察组术后引流管留置时间与住院时间均短于对照组，近期并发症发生率亦低于对照组，差异均有统计学意义（P<0.05）。结论胸腔镜下滑石粉胸膜固定术在控制恶性胸腔积液的有效性和安全性方面均优于胸腔闭式引流胸腔内灌注滑石粉。

Clinical analysis of medical thoracoscopic pleurodesis in the treatment of malignant pleural effusion in patients with advanced lung cancer

Objective To compare the clinical effect of medical thoracoscopic pleurodesis and pouring talcum powder after closed drainage of pleural cavity in the treatment of malignant pleural effusion in patients with advanced lung cancer. Methods 31 cases of malignant pleural effusion with advanced lung cancer from Jan.2014 to Oct.2016 were selected as observation group.Another 33 cases of malignant pleural effusion with advanced lung cancer from Jan.2011 to Dec.2013 were selected as control group.The cases in observation group were taken medical thoracoscopic pleurodesis and control group were taken pouring talcum powder after closed drainage of pleural cavity. The time of drainage tube intubation,length of stay,complications and hydrothorax control of the two groups were compared. Results After 12 weeks,the complete remission rate of observation group was 90.3% and the effective rate was 96.8% .The complete remission rate of control group was 33.3% and the effective rate was 63.6%.There are significant differences between the two groups in terms of complete remission rate and effective rate(P<0.05).The time of drainage tube intubation, length of stay and incidence rate of complication in observation group was shorter than control group. There was statistically significance.Conclusion Medical thoracoscopic pleurodesis was more safe and effective than pouring talcum powder after closed drainage of pleural cavity in the treatment of malignant pleural effusion in patients with advanced lung cancer.