论文部分内容阅读
目的探讨胸腔镜手术在肺结核外科治疗中的价值。方法回顾分析北京大学深圳医院胸外科2007年6月—2016年6月间接受外科手术治疗的68例肺结核球患者的临床特征。结果 68例肺结核球患者,男性38例,女性30例,年龄20~61岁,平均(38.4±12.4)岁。病变位于左肺上叶8例,左肺下叶25例,右肺上叶12例,右肺下叶23例。40例接受胸腔镜治疗,28例接受开胸手术治疗,无围手术期死亡,无术中大出血、支气管胸膜瘘和呼吸衰竭等重大并发症。共行楔形切除术64例,肺叶切除术4例,肺叶切除腔镜组开胸组各2例。胸腔镜组和开胸组手术平均时间、术中出血量、平均术后留管时间、平均住院时间分别为(152.4±59.5)min、(112.2±48.4)mL、(4.2±1.9)d、(7.4±2.2)d和(195.0±55.3)min、(333.7±107.9)mL、(6.6±2.3)d和(11.4±2.7)d,差异均有统计学意义(P<0.001)。结论胸腔镜手术是治疗肺结核球安全有效的方法,与开胸手术相比不增加围手术期死亡和并发症,但创伤更小,恢复更快,住院时间更短。
Objective To investigate the value of thoracoscopic surgery in the surgical treatment of pulmonary tuberculosis. Methods The clinical features of 68 patients with tuberculosis who underwent surgery surgically from June 2007 to June 2016 at Shenzhen Hospital of Peking University were retrospectively analyzed. Results 68 cases of tuberculosis patients, 38 males and 30 females, aged 20 to 61 years (mean, 38.4 ± 12.4 years). Lesion in the left upper lobe in 8 cases, 25 cases of left lower lobe, right upper lobe in 12 cases, right lower lobe in 23 cases. Forty patients underwent thoracoscopic surgery and 28 underwent thoracotomy. There were no perioperative deaths, no major intraoperative hemorrhage, bronchopleural fistulas and respiratory complications. There were 64 cases of wedge resection, 4 cases of lobectomy, and 2 cases of lobectomy group. The mean operative time, intraoperative blood loss, average duration of postoperative stay, and hospital stay were (152.4 ± 59.5) min, (112.2 ± 48.4) mL and (4.2 ± 1.9) d in the thoracoscopic and thoracic groups, respectively 7.4 ± 2.2) d and (195.0 ± 55.3) min, (333.7 ± 107.9) mL, (6.6 ± 2.3) d and (11.4 ± 2.7) d, respectively. There were significant differences between the two groups (P <0.001). Conclusions Thoracoscopic surgery is a safe and effective method for the treatment of pulmonary tuberculosis. Compared with thoracotomy, thoracoscope surgery does not increase the perioperative mortality and complications, but it has less trauma, faster recovery and shorter hospital stay.