老年慢性脓胸行胸膜纤维板剥脱术治疗方式的临床研究  

Clinical study of decortication in treatment of senile chronic empyema

作　　者：赵纯[1] 

机构地区：[1]浙江省丽水市中心医院胸外科,323000

出　　处：《中国医师进修杂志》2014年第23期12-14,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较胸腔镜下胸膜纤维板剥脱术与常规开胸胸膜纤维板剥脱术治疗老年慢性脓胸的术中、术后结果。方法选择32例老年慢性脓胸患者，10例接受胸腔镜下手术治疗（胸腔镜手术组），22例接受开胸手术治疗（常规开胸手术组）。比较两组手术时间、术中出血量、术后胸液总引流量、术后胸腔引流管留置时间、术后胸腔内冲洗时间、术后住院时间、术后应用抗生素时间以及术后并发症。结果两组手术时间比较差异无统计学意义（P〉0．05），胸腔镜手术组术中出血量、术后胸腔引流管留置时间、术后胸液总引流量、术后胸腔内冲洗时间、术后应用抗生素时间、术后住院时间均明显优于常规开胸手术组[（331．00±84．65）ml比（453．18±93．47）ml、（8．80±2．53）d比（11．59±3．57）d、（2357．00±649．03）ml比（3166．82±613．42）ml、（5．50±2．22）d比（7．68±2．95）d、（7．40±1．65）d比（9．45±2．58）d、（12．20±3．65）d比（15．32±4．04）d]，差异有统计学意义（P〈0．05）。结论胸腔镜下胸膜纤维板剥脱术治疗老年慢性脓胸安全、有效。Objective To compare the safety and feasibility of thoracoscope decortication and conventional thoracotomy decortication in treatment of senile chronic empyema. Methods Thirty-two patients with senile chronic empyema were selected, among total there were 10 patients received thoracoscope decortication （thoracoscope group） and 22 patients received conventional thoracotomy decortication （conventional thoracotomy group）. The operative time,intraoperative bleeding volume,postoperative total hydrothorax drainage volume,postoperative drainage time,postoperative thoracic rinse time,postoperative length of stay in hospital and postoperative antibiotic application time were compared between 2 groups. Results There was no statistical difference in operative time between 2 groups （P 〉 0.05 ）. The intraoperative bleeding volume, postoperative drainage time, postoperative total hydrothorax drainage volume, postoperative thoracic rinse time,postoperative antibiotic application time,postoperative length of stay in hospital in thoracoscope group were significantly better than those in conventional thoracotomy group [ （331.00 ± 84.65 ） ml vs. （453.18 ±93.47） ml, （8.80 ±2.53） d vs. （11.59 ±3.57） d, （2 357.00 ±649.03） ml vs. （3 166.82 ±613.42） ml, （5.50 ±2.22） d vs. （7.68 ±2.95） d, （7.40 ± 1.65） d vs. （9.45 ±2.58） d, （ 12.20 ± 3.65 ） d vs. （ 15.32 ± 4.04 ） d ], there were statistical differences （P 〈 0.05 ）. Conclusion Thorac oscope decortication is safe and feasible in treatment of senile chronic empyema.

关 键 词：积脓 胸腔 老年人 胸膜纤维板剥脱术 胸腔镜 

分 类 号：R655[医药卫生—外科学]