电视胸腔镜辅助胸膜纤维板剥脱术治疗结核性脓胸患者围手术指标、心肺功能及并发症的影响  

The effects of video-assisted thoracoscopic pleural fibrous plate stripping on perioperative indexes, cardiopulmonary function and complications in patients with tuberculous empyema

作　　者：降初拉尔布 肖航宇[1] 徐孟[1] 张曜[1] 樊谦 张怡 JIANG CHU LA ER BU;XIAO Hang-yu;XU Meng;ZHANG Yao;FAN Qian;ZHANG Yi(People′s Hospital of Ganzi Tibetan Autonomous Prefecture,Kangding 626000,China)

机构地区：[1]甘孜藏族自治州人民医院,四川康定626000

出　　处：《实用医院临床杂志》2022年第5期150-153,共4页Practical Journal of Clinical Medicine

摘　　要：目的 研究电视胸腔镜辅助胸膜纤维板剥脱术治疗结核性脓胸患者围手术指标、心肺功能及并发症的影响。方法 选取2016年1月至2021年10月在我院就诊的113例结核性脓胸患者,根据手术方案不同分为研究组58例(电视胸腔镜辅助胸膜纤维板剥脱术治疗)和对照组55例(传统开胸手术治疗)。比较两组临床疗效、手术指标、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD);用力肺活量(FVC)、1秒用力呼气容器(FEV)、1秒用力呼气容积占用力肺活量的百分比(FEV/FVC%)及并发症。结果 研究组总有效率(91.38%)高于对照组(76.36%)(P<0.05);研究组手术时间、术中出血量、引流管放置时间、住院天数均少于对照组(P<0.05);治疗后研究组LVEDD、LVESD低于对照组,LVEF、FVC、FEV、FEV/FVC高于对照组(P<0.05);研究组并发症率(5.17%)低于对照组(18.18%)(P<0.05)。结论 电视胸腔镜辅助胸膜纤维板剥脱术可提升结核性脓胸的治疗疗效,能够改善患者心肺功能,有利于术后恢复,安全性高。Objective To investigate the effects of video-assisted thoracoscopic pleural fibrous plate stripping on perioperative indexes, cardiopulmonary function and complications in patients with tuberculous empyema.Methods One hundred thirteen patients with tuberculous empyema treated in our hospital from January 2016 to October 2021 were selected. According to different surgical plans, they were divided into a study group(n=58) and a control group(n=55). The study group was treated with video-assisted thoracoscopic pleural fibrous plate stripping and the control group was treated with traditional thoracotomy. The clinical efficacy, surgical indicators, cardiopulmonary function [left ventricular ejection fraction(LVEF), left ventricular end diastolic dimension(LVEDD), left ventricular end systolic dimension(LVESD), forced vital capacity(FVC), forced expiratory volume in 1 second(FEV), and percentage of forced expiratory volume in first second to forced vital capacity(FEV/FVC%)] and complications were compared between the two groups.Results The total effective rate of the study group(91.38%) was higher than that of the control group(76.36%)(P<0.05). The operation time, intraoperative blood loss, drainage tube placement time, and hospitalization days of the study group were all less than those of the control group(P<0.05). After treatment, LVEDD and LVESD in the study group were lower than those in the control group, and LVEF, FVC, FEV, FEV/FVC% in the study group were higher than those in the control group(P<0.05). The complication rate in the study group(5.17%) was lower than that in the control group(18.18%)(P<0.05). Conclusion Video-assisted thoracoscopic pleural dissection can improve the curative effect of tuberculous empyema, improve the cardiopulmonary function, and facilitate the postoperative recovery. Its safety is also high.

关 键 词：结核性脓胸 电视胸腔镜 胸膜纤维板剥脱术 心肺功能 并发症 

分 类 号：R655[医药卫生—外科学]