Surgical salvage in pulmonary tuberculosis.
Surgical salvage in pulmonary tuberculosis.
复制标题
肺结核的手术挽救。
DOI：
10.1016/s0003-4975(10)65716-5
复制
发表时间：
1974
影响因子：
4.6
通讯作者：
G. Gale
中科院分区：
文献类型：
--
作者：
N. Delarue;G. Gale
肺结核患者的手术治疗史表明，即使在挽救领域，手术干预的需求也在迅速下降。尽管如此，在治疗复杂的结核病的技术已被证明是适用于管理的挑战性的问题，不涉及tuberculosis.本报告总结了抢救性切除术，抢救性皮质剥脱术，抢救性胸廓成形术所取得的成果，并指出，价值超过风险，即使在危重患者。重点放在持久的空间和消除这些空腔的方法的意义。骨成形胸廓成形术被建议作为一种预防性技术和“定制”程序作为一个明确的机动。当感染患者需要去皮质术时，最好是脓胸摘除术。这些患者存在支气管胸膜瘘会产生危及生命的风险，通过使用肋间肌移植物可以提高闭合的安全性。一种技术应用移植物进行了简要说明。
The history of the surgical treatment of patients with pulmonary tuberculosis illustrates the rapidly declining need for operative intervention, even in the salvage area. Nonetheless the techniques which were largely developed and refined in treating complicated tuberculous disease have proved to be applicable in the management of challenging problems not involving tuberculosis.This report summarizes the results achieved by salvage resection, salvage decortication, and salvage thoracoplasty and indicates that the value exceeds the risk, even in critically ill patients. Emphasis is placed on the significance of persisting spaces and the methods of obliterating these cavities. Osteoplastic thoracoplasty is advised as a prophylactic technique and the “tailored” procedure as a definitive maneuver. When decortication is required in infected patients, enucleation of the empyema is preferable. The presence of a bronchopleural fistula in these patients creates life-endangering risks, and the security of closure can be improved by the utilization of intercostal muscle grafts. A technique for applying the graft is briefly described.