两种方法治疗胸壁结核的疗效比较  

Comparison of the effect of two treatment methods for thoracic tuberculosis

作　　者：吴常青[1] 王力维[1] 唐弘杰 卞傲傲[1] 韩洲[1] 

机构地区：[1]苏州市第五人民医院外科,江苏省苏州215007

出　　处：《中国基层医药》2017年第19期2893-2896,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨两种方法治疗胸壁结核的临床效果。方法61例胸壁结核患者按手术方式不同分为A、B两组，其中A组31例，B组30例。A组行单纯胸壁结核软组织病灶清除术，B组行病灶清除＋肋骨切除＋肌瓣填塞术。对两组手术时间、疼痛时间、拔管时间、住院时间、伤口积液、治愈率和复发率等指标进行比较。结果A组手术时间、疼痛时间、住院时间等较B组短，差异均有统计学意义[（35．0±11．0）min比（50．0±9．5）min，（1．8±1．3）d比（4．2±2.4）d，（12．5±3．4）d比（18．8±5．7）d，t=6．257、4．275、5．334，均P〈0．05]；两组拔管时间、伤口积液、治愈率和复发率等差异均无统计学意义[（5．8±3．1）d比（5．5±2．8）d，2例比1例，100．0％比100．0％，6．4％比3．3％，t=8．691，）（2=9．867、13．674、15．871，均P〉0．05]。结论对胸壁结核应具体情况个体化分析，如有肋骨破坏则应采取病灶清除＋肋骨切除术＋肌瓣填塞术，若无肋骨破坏行单纯胸壁结核软组织病灶清除术更为安全，对患者而言创伤也更小。Objective To explore the efficacy of two treatment methods for thoracic tuberculosis. Methods According to the different surgical methods,61 patients with thoracic tuberculosis were randomly divided into A group （31 cases） and B group （30 cases）. A group was treated with simple thoracic tuberculosis soft tissue lesions removed, and B group was treated with focus removal ＋ rib resection ＋ muscle flap packing. The operation time, pain time, extubation time, hospital stay, wound fluid, cure rate and recurrence rate were compared between the two groups. Results The operation time,pain time, hospital stay time of A group were shorter than those of B group [ （35.0 ± 11.0）minvs.（50. 0±9.5）min,（1.8 ±1.3）d vs. （4.2±2.4）d,（12.5 ±3.4）d vs. （18.8 ±5.7）d],the differences were statistically significant（ t = 6.257,4. 275,5. 334, all P 〈 0. 05）. There were no statistically significant differences in the extubation time, wound effusion, cure rate and recurrence rate between the two groups [ （ 5.8 ± 3.1）d vs. （5.5 ±2.8）d,2 cases vs. 1 case,100.0% vs. 100.0% ,6.4% vs. 3.3% ,t =8.691 ,χ2 =9.867,13.674, 15. 871,all P 〉 0.05 ]. Conclusion Analysis of the specific situation should be individualized on the chest wall tuberculosis,in the case of rib destruction, the focus should be removed ＋ rib resection ＋ muscle flap packing, if there is no rib destruction, simple chest wall tuberculosis soft tissue lesions removal is more safe, because it is less traumatic for patients.

关 键 词：结核 胸壁 疗效比较研究 

分 类 号：R655.1[医药卫生—外科学]