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目的:探讨微创胸腔闭式引流治疗肺结核并发自发性气胸的临床疗效。方法:局部麻醉下将16FR导管置入患者胸腔,外接持续胸腔闭式引流治疗45例肺结核并发自发性气胸患者。结果:45例患者中,发生气胸时间1~6 d,平均3.7 d,发生气胸后肺被压缩面积40%~90%,平均68.8%。治愈43例,治愈率95.6%。其中32例单纯引流,13例加用持续负压吸引或空针抽吸治疗后治愈;2例治疗无效转外科手术。3例发生轻度皮下气肿,无1例发生发生感染、出血、医源性气胸、复张性肺水肿等并发症。结论:16FR导管置入胸腔闭式引流治疗肺结核并发自发性气胸,操作简单,创伤小,费用少,疗效好,复发率低,值得临床推广。
Objective: To investigate the clinical effect of minimally invasive thoracic closed drainage in the treatment of pulmonary tuberculosis complicated with spontaneous pneumothorax. Methods: 16FR catheters were implanted into the thorax of patients under local anesthesia, and 45 patients with pulmonary tuberculosis complicated with spontaneous pneumothorax were treated with continuous closed thoracic drainage. Results: Of the 45 patients, pneumothorax occurred for 1-6 days, with an average of 3.7 days. Compressed area of the lung after pneumothorax was 40% -90% with an average of 68.8%. 43 cases were cured, the cure rate was 95.6%. Among them, 32 cases were treated by simple drainage, 13 cases were treated with continuous vacuum suction or empty needle aspiration, and 2 cases were treated with ineffective surgery. 3 cases of mild subcutaneous emphysema, no case of infection, hemorrhage, iatrogenic pneumothorax, complications such as recurrent pulmonary edema. Conclusion: 16FR catheter into thoracic closed drainage treatment of pulmonary tuberculosis complicated with spontaneous pneumothorax, simple operation, less trauma, less cost, good curative effect, low recurrence rate is worthy of clinical promotion.