摘要
目的总结急诊手术治疗肺结核并发大咯血的经验。方法回顾性总结2005年6月-2015年12月我科急诊手术治疗的45例肺结核并发大咯血患者的临床资料。本组男性39例,女性6例,平均年龄47.5岁。手术方式为肺叶切除术和全肺切除术。结果 45例中,1例术中死亡,1例术后并发严重肺部感染于第7天死亡。1例术后呼吸功能不全,无法脱离呼吸机于术后13 d家属放弃治疗。2例术后早期出现支气管胸膜瘘,经胸腔冲洗引流治疗转为慢性脓胸,长期带胸腔引流管生存。2例术后胸腔出血,经二次开胸止血后恢复顺利。其余38例术后均恢复顺利。结论肺结核大咯血患者迅速切除病肺是手术成功的关键,手术方式首选肺叶切除;术后精细管理可有效预防并发症的发生。
Objective To summarize the treatment experience of emergency operation for pulmonary tuberculosis complicated with massive hemoptysis. Methods Clinical data about 45 inpatients with pulmonary tuberculosis complicated with massive hemoptysis received emergency operation in our hospital from June 2005 to December 2015 were retrospectively analyzed. There were 39 male and 6 female patients with average age of 47.5 years old. Their operation methods included lobectomy and total pneumonectomy. Results Of the 45 patients, one patient died during the operation, one patient died at seven days after surgery because of severe pulmonary infection, and one patient gave up treatment at 13 days after surgery for the respiratory insufficiency and extubation failure. Bronchopleural fistula occurred in two patients during the early stage after surgery, and it turned to be chronic empyema after thoracic rinsing and drainage. The patients survived and discharged with drainage tube. Hemothorax occurred in two patients after operation, then they received surgical hemostasis and recovered. Other 38 patients recovered. Conclusion For patients with pulmonary tuberculosis complicated with massive hemoptysis, immediate pulmonary resection is the key for the success of surgery. Lobectomy is the first choice. Precise management after surgery can effectively prevent complications.
作者
刘慧峰
马连君
郑梦利
赵亚超
祁彦君
张书新
LIU Huifeng MA Lianjun ZHENG Mengli ZHAO Yachao QI Yanjun ZHANG Shuxin(Department of Thoracic Surgery, Chinese PLA 309 Hospital, Beijing 100091, China)
出处
《解放军医学院学报》
CAS
2016年第12期1245-1247,1251,共4页
Academic Journal of Chinese PLA Medical School
基金
解放军第309医院面上课题项目(2016MS-007)
关键词
肺结核
大咯血
肺切除术
pulmonary tuberculosis
massive hemoptysis
pneumonectomy
