空洞清除术治疗复治菌阳空洞型肺结核临床研究.doc

空洞清除术治疗复治菌阳空洞型肺结核临床研究.doc空洞清除术治疗复治菌阳空洞型肺结核临床研究中华结核和呼吸感染1999年第9期第22卷论著作者:魏成宽于红梅张瑞霞陈松峰李荫良王林单位:130062长春市结核病医院胸外科关键词:结核,肺;空洞清除术【摘要】目的寻找通过外科手段治疗内科无法根治的复治耐多药菌阳重症空洞型肺结核的有效途径。方法1981〜1998年6月采用空洞清除术治疗复治耐药空洞型帥结核104例。切除覆盖在空洞外侧的肋骨后段,游离相应部位的带蒂肋间组织,剪除空洞外侧壁,彻底淸除空洞内容物,刮出新鲜创面,有机酸杀灭可能残留的结核分支杆菌,将准备好的肋间肌瓣填充于空洞残腔内,缝合固定。结果104例中出院时治愈103例(%),其中一•次于术治愈101例(%),好转1例(%)。随访98例中,复工率96%,无手术死亡和复发者。结论空洞淸除术设计合理,是治疗内科无法根治的复治菌阳空洞型肺结核的有效方法。CleaningcavityoperationintreatingrelapsebacillarycavitarypulmonarytuberculosisWEIChengkuan,YUHongmei,ZHANGRuixiaChangchunTuberculosisHospital,Changchun130062【Abstract]・Theoperationcontainedresectingthebackribcoveringthecavity,separatingtheintercostaltissue,cuttingtheexternalwallofthecavity,cleaningthecavitythoroughly,scrapingthecavitytillexposingthefreshtissue,anicacid,fillingthecavitywiththeintercostalmuscle,,103cases(%)werecured,101cases(9&1%)werecuredafterthefirstoperation,onecase(%),therateofreturningtoworkwere96%,noonediedorrelapsed・ConclusionsThedesignofcleaningcavityoperationisreasonableanditistheeffectivemethodtotreattherelapsebacillarycavitarypulmon