胸腔镜引流与置深静脉导管引流治疗单纯性结核性胸膜炎对比分析  

A Comparative Analysis of the Effects of Drainage by Medical Thoracoscopy and through Deep Venous Catheter in Treatment of Simple Exudative Tuberculous Pleurisy

作　　者：许菊秀[1,2] 肖卫[1,2] 周全[1,2] 李芬[1,2] 马家兰[1,2] 陈振平[1,2] 

机构地区：[1]长江大学临床医学院 [2]荆州市第一人民医院呼吸内科,湖北荆州434000

出　　处：《长江大学学报（自科版）（下旬）》2015年第2期4-6,2,共3页Journal of Yangtze University

摘　　要：目的:探讨内科胸腔镜配合闭式胸腔引流术治疗单纯性、渗出性、结核性胸膜炎的优势。方法:比较内科胸腔镜检查联合胸腔闭式引流胸腔积液与胸腔穿刺活检后一次性胸腔内置入深静脉导管引流胸腔积液在诊断与治疗方面的效果。单纯性结核性胸膜炎患者35例,分为治疗组和对照组。治疗组18例直接采用内科胸腔镜检查配合胸腔闭式引流术;对照组17例胸腔穿刺活检后留置一次性深静脉导管分次引流胸腔积液。观察其活检阳性率、积液分隔包裹率、胸水控制时间、住院天数及6月后胸膜增厚发生率。结果:治疗组胸膜活检阳性率明显高于对照组,而积液分隔包裹发生率、胸水控制时间、住院天数、6月疗程结束后胸膜肥厚情况明显低于对照组。两组比较有统计学差异(P<0.05)。结论:内科胸腔镜配合闭式胸腔引流术治疗单纯性渗出性结核性胸膜炎疗效更确切,后遗症更少。Objective:To explore the advantages of closed thoracic drainage with medical thoracoscopy in treatment of simple exudative tuberculous pleurisy.Methods:35patients with simple exudative tuberculous pleurisy in the First Hospital of Yangtze University were analyzed retrospectively from January 2010 to February 2012.Among them 18 cases in the treatment group were treated with closed thoracic drainage with medical thoracoscopy,while 17 cases in the control group were treated with pleural fluid drainage with deep venous catheter.Results:The positive rate of pleural biopsy in the treatment group was much higher than the control group.The incidence rate of separate fluid inclusions,the time of pleural effusion control,the hospitalization days and the condition of pleural thickening after 6-month treatment were significantly lower than the control group and there were significant differences(P<0.05).Conclusion:The closed thoracic drainage with medical thoracoscopy in the diagnosis and treatment of simple exudative tuberculous pleurisy is more effective with less sequelae.

关 键 词：内科胸腔镜 结核性胸膜炎 胸膜活检 诊断 治疗 

分 类 号：R521.7[医药卫生—内科学]