传统方法与胸腔镜处理小儿脓胸的比较分析

Comparative Study of Conventional Therapy and Video Assisted Thoracoscopic Surgery for Empyema Thoracis in Children

摘要:

目的：评价不同治疗方法对小儿脓胸的治疗价值。方法：将9年中43例小儿脓胸分为用传统方法(A组)和电视胸腔镜手术(B组)处理两组，对其术后各种参数进行回顾性分析。结果：两组并发症的发生率和死亡率差异无显著性(P> 0.05)，但术后发热时间、抗生素应用时间、胸管留置时间和住院时间B组均短于A组［(2.8±1.7) d vs (5.7±2.1) d, (7.6±2.5) d vs (13.8±4.7) d, (3.8±1.6) d vs (5.8±2.4) d, (10.4±3.0) d vs (17.8±5.6) d］(P<0.01)。结论：电视胸腔镜处理小儿脓胸创伤小，疗效好，疗程短，但应尽早施行。

Abstract:

OBJECTIVE: To evaluate the value of video-assisted thoracospic surgery (VATS) for the treatment of pediatric empyema thoracis. METHODS: Forty three children with empyema thoracis between January, 1992 and February, 2001, over a period of 9 years, were treated by conventional therapy (thoracentesis, chest tube drainage or thoracotomy debridement; Group A, n=28) and VATS (Group B, n=15). Postoperative parameters of the two groups were reviewed retrospectively. RESULTS: The duration of fever, antibiotical therapy, chest tube drainage and hospitalization in Group B was shorter than those in Group A [( 2.8 d ± 1.7 ) d vs ( 5.7 ± 2.1 ) d, ( 7.6 ± 2.5 ) d vs ( 13.8 ± 4.7 ) d, ( 3.8 ± 1.6 ) d vs ( 5.8 ± 2.4 ) d, ( 10.4 ± 3.0 ) d vs ( 17.8 ± 5.6 ) d, respectively] (P< 0.01 ). There was no difference in the incidence of postoperative complications and in mortality between the two groups. CONCLUSIONS: VATS for empyema thoracis was efficacious and less traumatic, and the duration of treatment was short. However, the treatment should be intervened as early as possible.