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为比较原发结核性脓胸与继发结核性脓胸的手术风险及术后早期治疗效果,本研究选取武汉市肺科医院外科2014年11月至2016年10月收治的慢性结核性脓胸行纤维板剥脱术的患者60例,按其病因分为原发组和继发组,原发组32例,继发组28例,对两组患者的手术时间、术中出血量、术后带管时间、术后1个月肺完全复张率进行比较.结果显示,原发组的手术时间为(190.63±67.06) min,术中失血量为(255.34±61.72) ml,术后带管时间为(7.03±2.34)d,均少于继发组[分别为(301.07±81.29) min、(504.39±115.56) ml、(14.37±4.03)d],差异均有统计学意义(t值分别为5.77、4.33、3.85,P值均＜0.01);原发组术后1个月肺完全复张率为90.6％(29/32),明显高于继发组(17.9％,5/28),差异有统计学意义(x2=32.20,P＜0.01).作者认为,相对于原发结核性脓胸,继发结核性脓胸手术治疗的难度大、风险高、早期恢复差;术前可以通过结核性脓胸分型对手术的风险和预后进行评估,以做好充分的术前准备工作.“,”Sixty chronic tuberculous empyema patients undergoing fibreboard stripping surgery from Surgery Department,Wuhan Pulmonary Hospital between November 2014 and October 2016 were divided into primary group (n=32) and secondary group (n=28) according to the causative factors.The operative duration,bleeding volume in surgery,postoperative drainage time and postoperative pulmonary re-expansion rate one month postoperative were detected to compare the risk and effect at early stage of primary and secondary tuberculous empyema.The operation duration,bleeding volume and postoperative drainage time of the primary group were statistically less than those of the secondary group ((190.63±67.06) min vs.(301.07±81.29) min,t=5.77;(255.34±61.72) ml vs.(504.39±115.56) ml,t=4.33;(7.03±2.34) dvs.(14.37±4.03) d,t=3.85;allP＜0.01);while the postoperative pulmonary re-expansion rate of primary group was statistically higher than that of secondary group (90.6 ％ (29/32) vs.17.9％ (5/28),x2 =32.20,P＜0.01).Based on the above data,compared to the primary tuberculous empyema,surgical treatment is more difficult,risky and ineffectively for secondary tuberculous empyema.Classify the tuberculosis empyema was beneficial to evaluate the surgical risk and prognosis for effective preparation before operation.