带蒂大网膜移植在难治性胸壁结核外科治疗中的应用

目的探讨在难治性胸壁结核手术中带蒂大网膜移植的临床应用及其疗效。方法回顾性分析2008年3月至2009年6月9例难治性胸壁结核患者临床资料，复发6例，巨大病灶3例。采用带蒂大网膜移植填塞残腔并缝合固定，术后持续绷带加压包扎2个月；随访9个月至2年。结果所有患者都一次手术治愈，术后继续抗结核治疗6—12个月，随访无一例复发。结论带蒂大网膜移植用于难治性胸壁结核患者的胸壁重建效果良好，可预防胸壁结核的复发。

Use of pedicled greater omentum graft in surgical management of refractory chest wall tuberculosis

Objective To explore the clinical application and curative effect of pedicled greater omentum graft in surgical management of refractory chest wall tuberculosis. Methods From March 2008 to June 2009,9 patients with refractory tuberculosis of the chest wall（6 recurrences ,3 large lesions）were treated by pedicled greater omentum grafting. In the operation, the pedicled greater omentum graft was used to stuff the residual cavity of the chest wall and then sutured and fixed to the chest wall. Pressure dressing with bandages was performed for 2 months after the operation. All the patients were followed up for 9 months to 2 years. Results The procedures were completed smoontly. All the patients were given antitu- berculous therapy for 6 to 12 mon after the operation and suffered no recurrence. Conclusion Pedicled greater omentum grafting is effective in the treatment of refractory chest wall tuberculosis with satisfactory clinical outcomes.