Daniel T M, Tribble C G, Rodgers B M
Department of Surgery, University of Virginia Health Sciences Center, Charlottesville 22908.
Ann Thorac Surg. 1990 Aug;50(2):186-9. doi: 10.1016/0003-4975(90)90730-t.
The indications, technique, and results of thoracoscopic talc poudrage in the two clinical settings of pneumothorax and recurrent pleural effusion in chronically ill patients are reported. Forty patients underwent this treatment between May 1982 and September 1989. The patients ranged in age from 10 months to 78 years. Of the 20 patients who underwent treatment of pneumothorax, 9 had cystic fibrosis, 7 had severe chronic obstructive pulmonary disease, 2 had spontaneous pneumothoraces, and 2 had postoperative parenchymal bronchopleural fistulas. Nineteen patients (95%) had successful treatment. Of the 20 patients who underwent treatment of chronic effusions, 14 had malignant etiologies, 3 had chylothoraces, and 3 had other miscellaneous effusions. Eighteen patients (90%) in this group had successful treatment. There were two hospital deaths related to the underlying disease processes after the pleural space problems were successfully treated. This study suggests that proper selection of patients and full exploitation of the capabilities of thoracoscopy and talc poudrage will result in effective treatment with low morbidity and mortality.
本文报告了在慢性疾病患者气胸和复发性胸腔积液这两种临床情况下，胸腔镜滑石粉喷洒术的适应证、技术及结果。1982年5月至1989年9月期间，40例患者接受了该治疗。患者年龄从10个月至78岁不等。在接受气胸治疗的20例患者中，9例患有囊性纤维化，7例患有严重慢性阻塞性肺疾病，2例为自发性气胸，2例为术后实质性支气管胸膜瘘。19例患者（95%）治疗成功。在接受慢性胸腔积液治疗的20例患者中，14例病因是恶性的，3例为乳糜胸，3例为其他各种胸腔积液。该组18例患者（90%）治疗成功。在胸腔问题成功治疗后，有2例患者因基础疾病过程在医院死亡。本研究表明，正确选择患者并充分利用胸腔镜和滑石粉喷洒术的能力，将实现低发病率和死亡率的有效治疗。
