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目的探讨慢性结核性脓胸患者围手术期护理的特点,以利于进一步提高护理质量,确保手术成功率和降低不良反应率.方法回顾性分析2006年1月至2011年12月在山东省胸科医院胸外科接受手术治疗的461例慢性结核性脓胸患者的临床资料.其中,男317例,女144例;年龄6~79岁,中位年龄33岁.总结461例慢性结核性脓胸患者围手术期的护理方法及效果.术前予以营养支持、心理护理、宣传教育、药物护理等,术后给予常规护理、呼吸道护理及呼吸功能锻炼、胸腔闭式引流管的观察及护理、观察并早期发现并发症等措施. 结果 经过护理措施,全组未发生围手术期死亡患者;461例中一次手术治愈445例,分期手术治愈6例.术后并发症:心律失常12例,经对症处理及护理治愈;肺不张7例,给予指导患者加强呼吸功能锻炼后均复张良好;肺部感染5例,给予抗炎并精细护理后治愈;支气管胸膜瘘1例,引流6个月后行瘘修补+肌瓣填塞术+局限性胸廓成形术后治愈;3例切口愈合不良,经过换药护理治愈.结论 对结核性脓胸手术患者实施针对性的健康指导、周密细致的围手术期护理,是减少结核性脓胸手术后并发症、确保手术成功、提高治愈率的重要保障. “,”Objective To explore the characteristics of perioperative care in patients with chronic tuberculous empyema, in order to further improve the quality of care, ensure the success rate of surgery and reduce the rate of adverse reactions. Methods The clinical data of 461 patients with chronic tuberculous empyema who underwent surgical treatment from Department of Thoracic Surgery in Shandong Provincial Chest Hospital from January 2006 to December 2011 were retrospectively analyzed.Including 317 males and 144 females;aged 6 to 79 years, median age 33 years old.We summarized the perioperative care methods of 461 patients with chronic tuberculous empyema.The patients were preoperatively given nutrition support, psychological care, education, drug careetc.Routine care, respiratory care and respiratory function exercise, thoracic closed drainage tube observation and care, observation and early detection of complications and other measures were taken postoperatively. Results All patients had no perioperative death occurred through our perioperative care.In the 461 cases, 445 cases were cured, while 6 cases were cured by staging surgery.Postoperative complications: 12 cases of arrhythmia, cured by symptomatic treatment and nursing.Patients with atelectasis in 7 cases, recovered after instructing patients to strengthen the respiratory function exercise.Lung infection in 5 cases, cured by taking the anti-inflammatory and precision nursing.Post-pneumonectomy fistula in 1 case, drainage of half year, cured after receiving fistula repair and muscle flap pedicle surgery and localized thoracic plasty.3 cases of incision healing, cured after dressing cure. Conclusion The implementation of targeted health guidance, careful and meticulous perioperative care for patients with tuberculous empyema surgery, are important guarantee for reducing the complications of surgery, ensuring the success of the operation and improving the cure rate.