Naumov V N, Karaeva G B
Probl Tuberk. 1993(5):23-6.
The results of surgical treatment have been summarized for 97 patients with disseminated progressive and complicated tuberculosis associated with respiratory disorders. Of them, 89 (91.8%) had fibrous-cavernous disease and empyema, 72.2% exhibited bilateral advanced process. Noticeable disturbances of ventilation capacity were registered in 47 patients, grave ones in 22 cases. Restrictive and obstructive types predominated. External respiration was impaired most seriously when the process was disseminated and progressive. Respiratory failure increased with growing rates of the disease progression. Pulmonectomy was performed in 58, primary and staged trans-sternal transpericardial occlusions of the main bronchi in 25 cases. The effect was reached in 83.5%, 16.5% of patients died. Lethal outcomes occurred due to bronchopleural complications in 43.8%, pulmonary artery thromboembolism in 18.7% of surgical cases. It is inferred that pulmonary dysfunction cannot be a principal criterion for rejecting operative treatment in progressive and complicated pulmonary tuberculosis.
对97例伴有呼吸系统疾病的播散性进展型复杂性肺结核患者的外科治疗结果进行了总结。其中，89例（91.8%）患有纤维空洞性疾病和脓胸，72.2%表现为双侧进展期病变。47例患者出现明显的通气功能障碍，22例为严重障碍。以限制性和阻塞性类型为主。当病情播散且进展时，外呼吸受损最为严重。呼吸衰竭随着疾病进展速度的加快而加重。58例行肺切除术，25例行一期和分期经胸骨经心包主支气管闭塞术。有效率达83.5%，16.5%的患者死亡。手术病例中，43.8%的致死结局是由于支气管胸膜并发症，18.7%是由于肺动脉血栓栓塞。据推断，肺功能障碍不能作为拒绝进展型复杂性肺结核手术治疗的主要标准。
