作　　者： (吴进超）; (高欣悦）; (王丽）;

机构地区： 吉林省结核病医院胸外科,长春130500

出　　处： 《中国防痨杂志》 2017年第9期961-963,共3页

摘　　要： 目的探讨胸膜剥脱术术后结核性脓胸患者肺功能的变化.方法 选取2010-2016年期间我院收治的符合手术指征的80例结核性脓胸患者施行胸膜剥脱术,本组80例患者中,男42例,女38例,年龄17-54岁,平均年龄（30.20±5.60）岁.全脓胸13例,占16.3%;局限性脓胸67例,占83.7%.患者手术前病程3-30个月,术前均经内科给予规范的抗结核药物治疗4-28个月,平均（7.60±4.60）个月;均曾行4-12次胸腔穿刺抽液,平均（6.00±4.20）次;其中53例患者曾接受过胸腔内注射尿激酶治疗.测定患者术前、术后6个月的肺功能指标,包括用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、最大呼气峰流速（PEF）和最大通气量（MVV）等,了解肺功能的变化.肺功能测定结果均按＂测定值/正常预计值×100%＂表示,所获得的计量资料以＂x±s＂表示,统计学处理采用t检验,以P〈0.05为差异有统计学意义.结果 80例患者手术顺利,术后恢复良好.术前、术后6个月肺功能监测指标FVC [分别为（70.60±10.12） %、（89.40±9.47） %]、FEV1 [分别为（68.00±9.23） %、（83.97±8.56） %]、PEF [分别为（67.20±11.04） %、（78.20±8.85） %]、MVV [分别为（60.60±15.63） %、（81.50±15.80） %],差异有统计学意义（t值分别为-6.585、-7.812、-3.965、-4.975,P值均〈0.05）,术后6个月较术前均有明显改善.结论 胸膜剥脱术可有效改善结核性脓胸患者的肺功能,对于有手术指征的单纯结核性脓胸患者,手术仍是最有意义的治疗方式. Objective To investigate the effects of pleural decortication on the pulmonary function in patients with tuberculous empyema. Methods Eighty patients with tuberculous empyema in our hospital from 2010 to 2016 were selected and treated with pleural decortication.In this group of 80 patients, there were 42 males and 38 females, average age （30.20±5.6 0） years old （ranged from 17 to 45 years old）.Whole empyema occurred in 13 cases （16.3%）,limited empyema occurred in 67 cases （83.7%）.The patients had a course of disease ranging from 3 to 30 months before the operation.The standard of anti-tuberculosis treatment was 4 to 28 months before operation （anaverage （7.60±4.60） months）.Both had undergone 4 to 12 thoracic drainage, （6.00±4.20） times on average.Of these, 53 patients had been treated with intrapleural urokinase.The levels of forced vital capacity （FVC）, forced expiratory volume in one second （FEV1）, peak expiratory flow （PEF） and maximal voluntary ventilation （MVV） in all cases before surgery and in 6 months after operation were observed to investigate the pulmonary function.The results of pulmonary function tests were expressed as ＂measured value/normal predictive value×100%＂, the measurement data obtained by ＂x±s＂, the t test was adopted, with P〈0.05 was statistically significant. Results All operations were successful, and the postoperative recovery of 80 cases of patients was well.The preoperative and postoperative 6 months of pulmonary function monitoring indexes of FVC （leave each other （70.60±10.12） %, （89.40 ＋ 9.47） %）, FEV1 （leave each other （68.00±9.23） %, （83.97±8.56） %）, PEF （leave each other （67.20±11.04） %, （78.20±8.85） %）, MVV （leave each other （60.60±15.63） %, （81.50±15.80） %）.The lung functions were significantly improved in patients after operation while compared with before surgery （t=-6.585,-7.812,-3.965,-4.975,P〈0.05）. Conclusion Pleural decortication can effectively amel

关 键 词： 脓胸 结核性 胸外科手术 胸廓成形术 呼吸功能试验 评价研究