改良式胸膜剥除术对慢性结核性脓胸手术适应证的探讨

徐业新 谢再伦 2005-12-13 13:49:36 中华医学研究杂志 2003年2月第3卷第2期

【摘要】 目的 探讨改良式胸膜纤维板剥除术的手术适应证。方法 剖胸后清除脓腔内坏死物质，常规保留胸壁层的纤维板，剥除脏层的纤维板。结果 本组手术无死亡，均为临床治愈出院。随访3～10年无复发。结论 改良术较传统术式适应证扩大，是治疗慢性结核性脓胸的较好方法。

关键词 结核性脓胸 胸膜剥除术 适应证

Indication of modified pulmonary decortication

for chronic tuberculous empyma

Xu Yexin，Xie Zailun

Department of Surgery，Chest Hospital of Jingzhou City，Hubei434000.

【Abstract】 Objective To study the indication of modified pulmonary decortication for chronic tuberculous empyma.Methods From the October1979to January1998，40cases of chronic tuberculous empyma had been treatˉed by using a modified technique of pulmonary decortication，removing of necrous material in pluera cavity.We reˉmained parietal fibrous plate as a routine operative procedure，and then had a decortication of viseral fibrous plate usˉing a usual operative methods.Results The prognosis was excellent in all cases.There was no mortality.No recurrent cases occurred in following-up3～10years postoperation.The indication of modified pulmonary decortication is wider than that of old pulmonary decorticatoin.Conclusion This modified technique may be applicable in most cases of chronic tuberculous empyma.The operating indication and contrary-indication are discussed.

Key words tuberculous empyma pulmonary decourication indication

慢性结核性脓胸，是以脏壁两层胸膜上纤维板肥厚（以壁层为主），肺受压或伴有支气管胸膜瘘（支瘘）等为主要病理改变，是内科无法根治，唯有外科手术才能彻底治愈的疾病。我院自1979年10月～1998年1月，采用改进的胸膜纤维板剥除术治疗40例慢性结核性脓胸，取得了较好疗效，就手术适应证方面进行了探讨。现总结如下。