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目的探讨电视胸腔镜手术治疗恶性胸腔积液的方法,总结其临床经验。方法回顾性分析2009年1月至2011年12月宝鸡市中心医院37例恶性胸腔积液患者的临床资料,男21例、女16例,年龄43~75岁。其中肺癌15例,乳腺癌7例,食管癌7例,胃癌4例,胸膜间皮瘤3例,卵巢癌1例;均为单侧胸腔积液,其中左侧胸腔积液22例,右侧胸腔积液15例。所有患者均行电视胸腔镜手术(VATS)或VATS辅助小切口完成手术,在电视胸腔镜下行胸膜剥脱术,并喷洒滑石粉固定胸膜。结果围术期无死亡,7例(18.9%)延长切口,手术时间(40.32±19.06)min,术中出血量(90.09±41.03)ml,术后(7.31±2.08)d拔除胸腔引流管,术后住院时间(9.02±3.11)d。手术有效率100%,其中完全缓解19例(51.4%)。术后出现轻度并发症,如肺部感染、持续性漏气和切口感染等,经对症处理治愈。结论电视胸腔镜治疗恶性胸腔积液是一种微创、有效、实用的治疗方法。
Objective To discuss the method of video-assisted thoracoscopic surgery for malignant pleural effusion and summarize its clinical experience. Methods The clinical data of 37 patients with malignant pleural effusion from January 2009 to December 2011 in Baoji Central Hospital were retrospectively analyzed. There were 21 males and 16 females aged 43-75 years old. There were 15 cases of lung cancer, 7 cases of breast cancer, 7 cases of esophageal cancer, 4 cases of gastric cancer, 3 cases of pleural mesothelioma, and 1 case of ovarian cancer. All of them were unilateral pleural effusions, of which 22 cases were left pleural effusions and the right side. Pleural effusion in 15 cases. All patients underwent video-assisted thoracoscopic surgery (VATS) or VATS-assisted small incision to complete the operation. Under video-assisted thoracic surgery, the pleura was removed and sprayed with talcum powder to fix the pleura. Results There was no death in perioperative period, 7 cases (18.9%) prolonged incision, operation time (40.32±19.06) min, intraoperative blood loss (90.09±41.03) ml, and chest tube drainage after operation (7.31±2.08) days. Post-hospitalization time (9.02 ± 3.11) d. The efficiency of surgery was 100%, of which 19 cases (51.4%) were completely relieved. Mild complications such as lung infections, persistent leaks, and incision infections occurred after surgery and were cured by symptomatic treatment. Conclusion Video-assisted thoracoscopic treatment of malignant pleural effusion is a minimally invasive, effective and practical treatment.