电视胸腔镜手术治疗恶性胸腔积液37例临床分析_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

王军岐 , 仝瑞锋 , 张保平

宝鸡市中心医院胸外科，陕西宝鸡 721008;

Corresponding author：

Keywords：

电视胸腔镜手术; 恶性胸腔积液; 胸膜剥脱术; 胸膜固定术; 滑石粉

DOI：

10.7507/1007-4848.20140200

Video：

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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。

Citation： 王军岐, 仝瑞锋, 张保平. 电视胸腔镜手术治疗恶性胸腔积液37例临床分析. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 697-699. doi: 10.7507/1007-4848.20140200 Copy

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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.	姚建国.胸腔镜胸膜切除术与闭式引流术治疗非小细胞肺癌伴恶性胸腔积液的对比研究.临床和实验医学杂志, 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.胸腔镜治疗恶性胸腔积液27例分析.当代医学, 2012, 18(1):145-146.
13.	范勇, 梁春宝, 孙昕, 等.经可弯曲内科胸腔镜干粉状滑石粉胸膜固定术治疗恶性胸腔积液.中国内镜杂志, 2008, 14(12):1321-1323.
14.	宋金涛, 闫天生.恶性胸腔积液的治疗现状.中国微创外科杂志, 2007, 7(8):820-821.

1. 张玉, 尤庆山, 孙迪, 等.恶性胸腔积液综合治疗进展.现代生物医学进展, 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. 姚建国.胸腔镜胸膜切除术与闭式引流术治疗非小细胞肺癌伴恶性胸腔积液的对比研究.临床和实验医学杂志, 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.胸腔镜治疗恶性胸腔积液27例分析.当代医学, 2012, 18(1):145-146.
13. 范勇, 梁春宝, 孙昕, 等.经可弯曲内科胸腔镜干粉状滑石粉胸膜固定术治疗恶性胸腔积液.中国内镜杂志, 2008, 14(12):1321-1323.
14. 宋金涛, 闫天生.恶性胸腔积液的治疗现状.中国微创外科杂志, 2007, 7(8):820-821.

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