摘要
目的：探讨电视胸腔镜内囊摘除治疗肺细粒棘球蚴的临床经验,以提高临床治疗水平。方法：回顾分析2009年1月至2014年12月收治的45例肺包虫病患者的临床资料,均于全麻下行电视胸腔镜手术。以腋中线第7/8肋间为观察孔,主、副操作孔位置根据病变位置确定,摘除肺细粒棘球蚴内囊。结果：45例手术均获成功,无一例死亡。手术时间平均（91.0±10.2）min,术中出血量平均（84.0±12.4）ml,胸腔引流管留置时间3～5 d。其中囊肿破裂2例,囊液污染导致过敏2例,内囊残腔感染1例,支气管残端瘘1例,术后咯血1例,经积极处理后痊愈。术后随访,1例于一年后复发。结论：胸腔镜肺细粒棘球蚴内囊摘除术具有手术创伤小、康复快等优点,疗效可靠,是安全、可行的,值得广泛推广。随着手术操作的熟练、精细及规范化,胸腔镜手术的适应证会不断扩展。
Objective：To summarize the clinical experience of minimally invasive video-assisted thoracoscopic surgery （VATS） on pulmonary echinococcosis granulosus,in order to improve the level of clinical treatment. Methods： The clinical data of 45 patients with pulmonary echinocoecosis granulosus from Jan. 2009 to Dec. 2014 were retrospectively analyzed, all of them were given VATS treat- ment to remove internal capsule of echinococcus granulosus under general anesthesia. The seventh or eighth intercostal space at midaxil- lary line was chosen as the observation port, and main and vice operation ports were decided by location of lesion for the removal of in- ternal capsule of echinoeoccus granulosus. Results：All operations were successful, no deaths occurred. The average operation time was （91.0 ~ 10.2 ） min and blood loss during operation was （ 84.0 -＋ 12.4） ml, and chest tube indwelling time was 3 to 5 d. Cyst acciden- tally ruptured during operation in 2 cases, allergic reaction occurred in 2 cases after cyst rupture, other complications included 1 case of hydatid residual cavity infection, 1 bronchial stump fistula and 1 postoperative hemoptysis, all the cases were cured after active treat- ment. Relapse occurred in 1 case within 1 year. Conclusions：VATS is a safe, feasible and preferred treatment for pulmonary echinococ- cosis granulosus with few trauma, quick recovery and reliable effect, and should be widely popularized. The indications of VATS will be broadened when skilled, careful and standard techniques are adopted.
出处
《腹腔镜外科杂志》
2015年第7期513-515,共3页
Journal of Laparoscopic Surgery
关键词
棘球蚴病
肺
内囊摘除术
胸腔镜检查
Echinococcosis, pulmonary
Excision of internal cyst
Thoracoscopy
