单孔胸腔镜下胸膜纤维板剥脱治疗非急性期脓胸的临床疗效  

Clinical efficacy of decortication of pleural fibreboard under uniportal video-assisted thoracoscope in treatment of non-acute thoracic empyema

作　　者：董星星 吕作利 周奕君 黄冰[2] 罗波[2] 魏育涛[1,3] DONG Xing-xing;LYU Zuo-li;ZHOU Yi-jun;HUANG Bing;LUO Bo;WEI Yu-tao(Medical College of Shihezi University,Shihezi Xinjiang 832008,China;Second Department of Thoracic and Cardiovascular Surgery,First Hospital Affiliated to Medical College of Shihezi University,Shihezi Xinjiang 832008,China;Department of Thoracic Surgery,East District of Jining First People′s Hospital,Jining Shandong 272000,China)

机构地区：[1]石河子大学医学院,新疆石河子832008 [2]石河子大学医学院第一附属医院心胸外二科,新疆石河子832008 [3]济宁市第一人民医院东院区胸外科,山东济宁272000

出　　处：《局解手术学杂志》2020年第3期239-242,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：兵团师域发展创新支持计划项目(2017BA043);石河子大学成果转化与技术推广项目(CGZH201703)。

摘　　要：目的探讨应用单孔胸腔镜胸膜纤维板治疗非急性期脓胸的疗效。方法回顾性分析2016年3月至2019年3月石河子大学医学院第一附属医院收治的55例应用单孔胸腔镜行胸膜纤维板剥脱手术治疗非急性期脓胸患者的临床资料。记录患者手术时间、术中出血量、术后胸腔引流管留置时间及术后住院时间,术后随访2~24个月,记录患者是否有不适症状。结果患者平均手术时间(141.05±40.52)min,平均术中出血量(152.82±43.78)mL,术后胸腔引流管平均留置时间(9.04±3.25)d,术后平均住院时间(10.05±3.25)d。术后所有患者发热、胸闷等不适症状明显好转,复查胸片及胸部CT显示肺组织膨胀良好,胸腔内无积气积液,患者生活质量提高,效果满意,随访期间未诉特殊不适。结论单孔胸腔镜下胸膜纤维板剥脱治疗非急性期脓胸具有创伤小、术后恢复快、切口美观等优点,安全可行,值得临床应用。Objective To explore the efficacy of decortication of pleural fibreboard under uniportal video-assisted thoracoscope in treatment of non-acute thoracic empyema.Methods The clinical data of 55 cases of non-acute thoracic empyema who performed pleural decortication by uniportal video-assisted thoracoscopic surgery in the first affiliated hospital of Shihezi university medical college from March 2016 to March 2019 were retrospectively analyzed.The operation time,intraoperative blood loss,drainage tube retention time and hospital stay after operation were recorded.All patients were followed up for 2 to 24 months,and the uncomfortable symptoms were recorded.Results The average operation time was(141.05±40.52)minutes,the average intraoperative bleeding volume was(152.82±43.78)mL,the average drainage tube retention time was(9.04±3.25)days,the average postoperative hospital stay was(10.05±3.25)days.The symptoms of fever and chest tightness had obviously improved after operation,the chest X-ray and CT showed that the lung tissue expanded well without accumulation of gas and fluid in the thorax,meanwhile the life quality of the patients had improved and the therapy effect was satisfactory,no recurrence was found during the follow-up.Conclusion Pleural decortication under uniportal video-assisted thoracoscope in the treatment of non-acute thoracic empyema has the advantages of less trauma,faster postoperative recovery,beautiful incision and so on,which is safe,feasible and worthy of clinical application.

关 键 词：胸膜剥脱 非急性期 脓胸 单孔胸腔镜 胸腔引流 胸膜粘连 

分 类 号：R615[医药卫生—外科学]