電視胸腔鏡手術治療惡性胸腔積液37例臨床分析_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

王軍岐 , 仝瑞鋒 , 張保平

寶雞市中心醫院胸外科，陜西寶雞 721008;

Corresponding?author：

Keywords：

電視胸腔鏡手術; 惡性胸腔積液; 胸膜剝脫術; 胸膜固定術; 滑石粉

DOI：

10.7507/1007-4848.20140200

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目的探討電視胸腔鏡手術治療惡性胸腔積液的方法，總結其臨床經驗。方法回顧性分析2009年1月至2011年12月寶雞市中心醫院37例惡性胸腔積液患者的臨床資料, 男21例、女16例, 年齡43～75歲。其中肺癌15例，乳腺癌7例，食管癌7例，胃癌4例，胸膜間皮瘤3例，卵巢癌1例；均為單側胸腔積液，其中左側胸腔積液22例, 右側胸腔積液15例。所有患者均行電視胸腔鏡手術(VATS)或VATS輔助小切口完成手術，在電視胸腔鏡下行胸膜剝脫術，并噴灑滑石粉固定胸膜。結果圍術期無死亡，7例（18.9%）延長切口，手術時間（40.32±19.06）min，術中出血量（90.09±41.03）ml，術后（7.31±2.08）d拔除胸腔引流管，術后住院時間（9.02±3.11）d。手術有效率100%，其中完全緩解19例（51.4%）。術后出現輕度并發癥，如肺部感染、持續性漏氣和切口感染等, 經對癥處理治愈。結論電視胸腔鏡治療惡性胸腔積液是一種微創、有效、實用的治療方法。

Citation： 王軍岐, 仝瑞鋒, 張保平. 電視胸腔鏡手術治療惡性胸腔積液37例臨床分析. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 697-699. doi: 10.7507/1007-4848.20140200 Copy

1.	張玉, 尤慶山, 孫迪, 等.惡性胸腔積液綜合治療進展.現代生物醫學進展, 2012, 12(17):3358-3361.
2.	Marrazzo A, Noto A, Casà L, et al. Video-thoracoscopic surgical pleurodesis in the management of malignant pleural effusion:the importance of an early intervention. J Pain Symptom Manage, 2005, 30(1):75-79.
3.	Decamp MM, Mentzer SJ, Swanson SJ, et al. Malignant effusive disease of the pleura and pericardium. Chest, 1997, 112(4 Suppl):291S-295S.
4.	Kilie D, Akay H, Kavukeu S, et al. Management of recurrent malignant pleural effusion with chemical pleurodesis.Surg Today, 2005, 35(8):634-638.
5.	Musani AI, Haas AR, Seijo L, et al. Outpatient management of malignant pleural effusions with small-bore, tunneled pleural catheters. Respiration, 2005, 71(6):559-566.
6.	Uzbeck MH, Almeida FA, Sarkiss MG, et al. Management of malignant pleural effusions. Adv Ther, 2010, 27(6):334-347.
7.	姚建國.胸腔鏡胸膜切除術與閉式引流術治療非小細胞肺癌伴惡性胸腔積液的對比研究.臨床和實驗醫學雜志, 2011, 10(6):438-439.
8.	Mallawathantri S, Lim WS, Kinnear W. Setting up a medical thoracoscopy service:Safety and efficacy. Thorax, 2004, 59(1, 2):40-41.
9.	Trotter D, Aly A, Siu L, et al. Video-assisted thoracoscopic(VATS)pleurodesis for malignant effusion:an Australian teaching hospital's experience. Heart Lung Circ, 2005, 14(2):93-97.
10.	Barbetakis N, Asteriou C, Papadopoulou F, et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions:a review of 400 cases. J Cardiothorac Surg, 2010, 5:27.
11.	Aelony Y. Dry talc pleurodesis via chest tube. Chest, 2003, 123(1):308.
12.	王威, 高松, 李建哲, 等.胸腔鏡治療惡性胸腔積液27例分析.當代醫學, 2012, 18(1):145-146.
13.	范勇, 梁春寶, 孫昕, 等.經可彎曲內科胸腔鏡干粉狀滑石粉胸膜固定術治療惡性胸腔積液.中國內鏡雜志, 2008, 14(12):1321-1323.
14.	宋金濤, 閆天生.惡性胸腔積液的治療現狀.中國微創外科雜志, 2007, 7(8):820-821.

1. 張玉, 尤慶山, 孫迪, 等.惡性胸腔積液綜合治療進展.現代生物醫學進展, 2012, 12(17):3358-3361.
2. Marrazzo A, Noto A, Casà L, et al. Video-thoracoscopic surgical pleurodesis in the management of malignant pleural effusion:the importance of an early intervention. J Pain Symptom Manage, 2005, 30(1):75-79.
3. Decamp MM, Mentzer SJ, Swanson SJ, et al. Malignant effusive disease of the pleura and pericardium. Chest, 1997, 112(4 Suppl):291S-295S.
4. Kilie D, Akay H, Kavukeu S, et al. Management of recurrent malignant pleural effusion with chemical pleurodesis.Surg Today, 2005, 35(8):634-638.
5. Musani AI, Haas AR, Seijo L, et al. Outpatient management of malignant pleural effusions with small-bore, tunneled pleural catheters. Respiration, 2005, 71(6):559-566.
6. Uzbeck MH, Almeida FA, Sarkiss MG, et al. Management of malignant pleural effusions. Adv Ther, 2010, 27(6):334-347.
7. 姚建國.胸腔鏡胸膜切除術與閉式引流術治療非小細胞肺癌伴惡性胸腔積液的對比研究.臨床和實驗醫學雜志, 2011, 10(6):438-439.
8. Mallawathantri S, Lim WS, Kinnear W. Setting up a medical thoracoscopy service:Safety and efficacy. Thorax, 2004, 59(1, 2):40-41.
9. Trotter D, Aly A, Siu L, et al. Video-assisted thoracoscopic(VATS)pleurodesis for malignant effusion:an Australian teaching hospital's experience. Heart Lung Circ, 2005, 14(2):93-97.
10. Barbetakis N, Asteriou C, Papadopoulou F, et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflation for control of malignant pleural effusions:a review of 400 cases. J Cardiothorac Surg, 2010, 5:27.
11. Aelony Y. Dry talc pleurodesis via chest tube. Chest, 2003, 123(1):308.
12. 王威, 高松, 李建哲, 等.胸腔鏡治療惡性胸腔積液27例分析.當代醫學, 2012, 18(1):145-146.
13. 范勇, 梁春寶, 孫昕, 等.經可彎曲內科胸腔鏡干粉狀滑石粉胸膜固定術治療惡性胸腔積液.中國內鏡雜志, 2008, 14(12):1321-1323.
14. 宋金濤, 閆天生.惡性胸腔積液的治療現狀.中國微創外科雜志, 2007, 7(8):820-821.

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電視胸腔鏡手術治療惡性胸腔積液37例臨床分析

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