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目的探讨胸腔镜在结核性胸腔积液早期诊断与治疗中的临床价值。方法选择2013年1月—2015年12月收治的拟诊结核性胸腔积液患者80例,随机分为观察组、对照组各40例。观察组入院7 d内行胸腔镜检查与治疗,对照组行内科保守治疗。比较两组影像学恢复正常时间、住院时间,统计治疗后3个月内实施开胸手术及肺叶切除比例。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果观察组影像学恢复正常时间和住院时间[(13.2±3.2)、(24.6±11.3)d]均短于对照组[(23.4±5.7)、(43.6±17.9)d](均P<0.05)。观察组实施开胸手术治疗比例和肺叶切除比例[2(5.0%)、1(2.5%)]均低于对照组[19(47.5%)、10(25.0%)](均P<0.05)。结论对于拟诊结核性胸膜炎患者,7 d内实施胸腔镜检查与治疗,能显著减少外科开胸手术比例,缩短住院时间。
Objective To investigate the clinical value of thoracoscopy in the early diagnosis and treatment of tuberculous pleural effusion. Methods Eighty patients with tuberculous pleural effusion diagnosed from January 2013 to December 2015 were randomly divided into observation group and control group with 40 cases each. The observation group was treated by thoracoscopy 7 days after admission and the control group received conservative treatment. The imaging recovery time and hospitalization time were compared between the two groups. Thoracotomy and lobectomy were performed within 3 months after treatment. Measurement data were compared using t test, count data were compared using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The imaging recovery time and length of stay in the observation group were shorter than those in the control group [(13.2 ± 3.2) and (24.6 ± 11.3) days, respectively] [(23.4 ± 5.7) and (43.6 ± 17.9) days, respectively] . The proportion of patients undergoing thoracotomy in the observation group and the proportion of lobectomy [2 (5.0%), 1 (2.5%)] were lower in the observation group than those in the control group [19 (47.5%), 10 (25.0%)] (all P <0.05). Conclusion For patients diagnosed with tuberculous pleurisy, thoracoscope examination and treatment within 7 days can significantly reduce the proportion of surgical thoracotomy and shorten the hospital stay.