120例胸壁结核外科治疗体会  

Clinical Experiences of the Surgical Treatment of Chest Wall Tuberculosis(120 Cases Report)

作　　者：钱勇[1] 杨继承[1] 袁跃西[1] 

机构地区：[1]湖南省长沙市中心医院胸心外科,长沙410004

出　　处：《中国现代手术学杂志》2011年第5期364-365,共2页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胸壁结核外科治疗的方法及临床疗效。方法 120例胸壁结核均在气管内插管全身麻醉下施行病灶清除术,术前正规抗结核治疗2周以上。有窦道的33例逐一切开,切除有病变的肋骨、肋软骨、胸骨,游离带蒂肌瓣填充残腔,络合碘液及生理盐水冲洗,置放链霉素粉或异烟肼液,伤口加压包扎3周以上,术后继续抗结核治疗6～9个月。结果全组围手术期无死亡病例。113例切口Ⅰ期愈合7,例伤口裂开,局部换药后Ⅱ期愈合。全部治愈出院,平均随访1年(3个月～2年),复发3例,经再次手术治愈。结论应用病灶清除术行胸壁结核的外科治疗是安全可行的。Objective To explore the methods and clinical effects of the surgical treatment for chest wall tuberculosis.Methods 120 cases of chest wall tuberculosis underwent surgical treatment after preoperatively standard anti-tuberculosis for more than 2 weeks.33 cases of sinus underwent excision of lesions of the ribs,sternum and rib cartilage,and free pedicled muscle flaps were used to fill the residual cavity,followed by placing streptomycin powder or isoniazid liquid.The wound was bandaged for more than 3 weeks.And continued postoperative antituberculous therapy was used for 6 to 9 months.Results There was no death during the operation period.The incisions healed in 113 cases,but dehiscence was appeared in 7 cases.All the cases cured in the average follow-up of 1 year（range,3 months to 2 years） except 3 cases relapsed after operation.Conclusion The application of debridement for chest wall tuberculosis is safe and feasible.

关 键 词：结核 胸壁 外科手术 

分 类 号：R655.1[医药卫生—外科学]