论文部分内容阅读
目的 探讨非结核分支杆菌 (NTM)肺病手术治疗的适应证、手术方式及其效果。方法 37例NTM肺病患者接受 38次肺切除术。术前 30例进行了化疗 ,平均用药 8个月 (1～ 4 6个月 )。手术方式包括 :胸膜全肺切除 2例 ,肺叶切除 33例 ,段切除 1例 ,楔形切除 1例。常规包埋支气管残端。术后有 33例给予化疗 ,用药基本同术前 ,平均用药 10个月 (1～ 37个月 )。结果 无手术死亡及手术并发症病例。术后痰菌阴转率 97%。平均随访时间 (35± 15 )个月 (1～ 5 5个月 ) ,1例楔形切除的病例于术后 2年复发。结论 对于空洞型病变 ,持续痰菌阳性 ,不能耐受化疗 ,或合并曲菌感染及咯血的NTM肺病患者应考虑手术治疗。肺叶切除为首选手术方式。
Objective To investigate the indications, surgical methods and effects of surgical treatment of non-tuberculosis mycobacterium tuberculosis (NTM). Thirty-seven patients with NTM lung disease underwent 38 lung resections. Thirty patients underwent chemotherapy before surgery, with an average of 8 months (range 1 to 46 months). Surgical methods include: pleural pneumonectomy in 2 cases, lobectomy in 33 cases, segmental resection in 1 case and wedge resection in 1 case. Conventional embedding bronchial stump. After the operation, 33 cases were given chemotherapy. The medication was basically the same as preoperative, with an average of 10 months (range 1 to 37 months). Results No surgical deaths and complications of surgery. Postoperative sputum negative conversion rate of 97%. The average follow-up time was (35 ± 15) months (1-5.5 months). One case of wedge resection recurred 2 years after operation. Conclusions Surgery should be considered in patients with NTM-type lung disease who have a cavity-typed lesion, who has a positive sputum count, is refractory to chemotherapy, or is associated with aspergillosis and hemoptysis. Lobectomy for the preferred surgical approach.