不同干预策略对胸壁结核易复发因素的研究

发布时间：2018-01-23 03:28

本文关键词： 胸壁结核复发因素干预对策　出处：《中华医院感染学杂志》2015年13期 　论文类型：期刊论文

【摘要】：目的对胸壁结核易复发的各项因素进行分析,并总结各种干预对策,为临床诊断治疗提供理论指导依据。方法回顾性调查2007年起收治胸壁结核患者857例的临床资料,对其复发相关资料进行危险因素分析。结果 857例胸壁结核患者术后复发62例,复发率为7.2%;患者有基础性疾病、抗痨治疗不规范、合并肺实质和(或)胸膜及纵隔内病灶、结核中毒症状未控制、术前未明确病灶来源、胸壁结核类型、术式选择不合理、术中病灶清除不彻底、未充分引流、术后出现并发症、切口延期愈合或不愈合、原切口部位及前胸壁、术后管理不当是胸壁结核患者术后复发的危险因素(P0.05),而与性别、胸壁结核发生在左、右侧等无关(P0.05)。结论胸壁结核易复发的因素较多,针对相关危险因素,应做好各项干预策略,降低复发率。
[Abstract]:Objective to analyze the factors of recurrence of chest wall tuberculosis and summarize various intervention measures. Methods the clinical data of 857 patients with chest wall tuberculosis since 2007 were retrospectively investigated. Results the recurrence rate was 7.2% in 857 patients with chest wall tuberculosis. Patients have basic diseases, anti-tuberculosis treatment is not standardized, complicated with pulmonary parenchyma and / or pleural and mediastinal lesions, tuberculosis poisoning symptoms are not controlled, the origin of the lesion was not identified, chest wall tuberculosis type, the choice of operation is not reasonable. The debridement was incomplete, the drainage was not sufficient, postoperative complications occurred, incision delayed healing or non-union, original incision site and anterior chest wall. Postoperative mismanagement was the risk factor of postoperative recurrence in patients with chest wall tuberculosis (P 0.05), while with sex, chest wall tuberculosis occurred in the left. Conclusion there are many risk factors for recurrence of chest wall tuberculosis. According to the related risk factors, intervention strategies should be done well to reduce the recurrence rate.
【作者单位】：浙江省中西医结合医院结核外科;
【基金】：浙江省中医药管理局基金资助项目(2011ZB107)
【分类号】：R529.0
【正文快照】： 胸壁结核主要是胸壁软组织、肋骨、胸骨的结核性病变,多继发于肺及胸膜结核,是一种常见的肺外结核,发生胸壁结核时常伴有骨骼破坏,常规的抗结核及抗炎治疗很难治愈,一旦脓肿破溃后皮肤创口长年不愈,严重者甚至可导致支气管与皮肤创口直接相通,患者生活质量明显下降,一般均需进

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