作　　者： (张运曾）; (金锋）; (王成）;

机构地区： 山东省胸科医院胸外科,济南250013

出　　处： 《中国防痨杂志》 2017年第9期1010-1013,共4页

摘　　要： 外科治疗是治愈结核病的重要手段.随着临床医生诊断和治疗的规范化和腔镜器械的不断更新,电视辅助胸腔镜手术（video-assisted thoracoscopic surgery,VATS）对肺结核的外科治疗进入了一个新阶段,从最初的胸腔镜下人工气胸萎陷术、肺胸膜活检术,到目前的胸腔镜下肺楔形切除术、肺叶切除术,以及全肺切除术、复合肺切除术等均取得了较大发展.与传统开胸手术相比,由于VATS可以降低术后急性疼痛,对肺功能影响小,术后并发症少,术后住院时间相应缩短等,使更多的肺结核患者接受了外科治疗.胸腔镜肺叶切除术是治疗肺结核的一种有效、微创的方法,较大范围的致密粘连、血管钙化的淋巴结及粘连的条索等依然是肺结核切除术中的难点,无论是在传统开胸手术还是VATS下处理.但是,随着技术和器械的不断成熟,VATS将更多地应用于肺部良性疾病的治疗. Surgical treatment is one of the important means in the cure of tuberculosis （TB）.With the standar-dization of diagnosis and treatment behaviors of clinical doctors as well as the development of endoscopic instruments, the treatment of pulmonary TB using video-assisted thoracoscopic surgery （VATS） has entered a new phase.From the initial artificial pneumothorax collapse therapy and the pleural and lung biopsy under the thoracoscope, to the current pulmonary wedge resection, resection of lung, pneumonectomy and composite pneumonectomy under the thoracoscopy have achieved great progress.Compared with the traditional thoracotomy, VATS can reduce postoperative pain, has less influence on lung function, and reduce postoperative complications and postoperative hospitalization time, etc., so it permit more TB patients to receive surgical treatment.VATS lobectomy is an effective and minimally invasive treatment for pulmonary TB patients.Wide range of dense adhesion, calcified lymph nodes and adhesive cords are still the difficulties in both traditional thoracotomy and resection of lung under VATS.However, as long with the technology and equipment become mature, VATS will be more and more applied in treatment of the pulmonary benign diseases.

关 键 词： 结核 肺 胸外科手术 电视辅助 外科手术 微创性 综述