文章摘要
郭庆凤 董庆 申宝忠 徐万海 崔键 李雅杰.信息管理系统下胸腔镜胸膜固定术治疗恶性胸腔积液[J].,2016,16(4):669-672
信息管理系统下胸腔镜胸膜固定术治疗恶性胸腔积液
Thoracoscopic Talc Pleurodesis for Control of Malignant Pleural Effusionsunder Information Management System
  
DOI:
中文关键词: 医院信息化  呼吸困难  胸腔积液  胸膜固定
英文关键词: Hospital Information  Dyspnea  Pleural Effusion  Pleurodesis
基金项目:国家高技术研究发展计划(863 计划)( 2012AA02A616);国家高技术研究发展计划(863 计划)( 2012AA02A601); 黑龙江省应用技术研究与开发计划项目(GA14C101)
作者单位
郭庆凤 董庆 申宝忠 徐万海 崔键 李雅杰 哈尔滨医科大学附属第四医院胸外科 哈尔滨医科大学附属第四医院 
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中文摘要:
      目的:分析基于信息管理系统的胸腔镜滑石粉胸膜固定术控制恶性胸腔积液患者术后的并发症,死亡率及生存时间。方法: 2011年9 月至2014 年10 月,一共400 个患者完成了胸腔镜辅下滑石粉胸膜固定术。对手术前后的患者的并发症,死亡率,成功 率和中位生存时间进行评价。结果:中位随访时间为40 个月(范围4-61 月)。所有患者的呼吸困难症状都得到明显缓解。围手术 期死亡率为0。患者对这一手术的耐受性良好,没有观察到明显的副作用。院内死亡率为2%,胸膜固定的成功率为85%。较差的 KS 评分及胸腔积液诊断到完成胸膜固定术之间的时间延误与院内死亡的发生明显相关。乳腺癌的生存情况最好,其次为卵巢 癌,淋巴瘤和胸膜间皮瘤。结论:胸腔镜滑石粉胸膜固定术是一项安全有效的操作,胸膜固定的成功率较高,呼吸困难会能够得到 长期有效的控制。
英文摘要:
      Objective:Aim of our study is to analyze morbidity, mortality and life expectancy following video thoracoscopic talc poudrage in patients with certain malignancies under information management system.Methods:From September 2011 to October 2014, 400 patients underwent video-assisted thoracic surgery (VATS) for malignant pleural effusion. The conditions of patients were assessed and graded before and after treatment concerning morbidity, mortality, success rate of pleurodesis and median survival.Results:The median duration of follow up was 40 months (range 4-61 months). All patients demonstrated notable improvement in dyspnea. Intraoperative mortality was zero. The procedure was well tolerated and no significant adverse effects were observed. In hospital mortality was 2% and the pleurodesis success rate was 85%. A poor Karnofsky Performance Status and delay between diagnosis of pleural effusion and pleurodesis were statistically significant factors for in-hospital mortality. The best survival was seen in breast cancer, followed by ovarian cancer, lymphoma and pleural mesothelioma.Conclusion:Video-assisted thoracoscopic talc poudrage is an effective and safe procedure that yields a high rate of successful pleurodesis and achieves long-term control with marked dyspnea decrease.
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