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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。
OBJECTIVE: To analyze postoperative complications, mortality and survival time of thoracoscopic talc pleurodesis in patients with malignant pleural effusion based on information management system. METHODS: From September 2011 to October 2014, a total of 400 patients underwent thoracoscopic assisted talc pleurodesis. Complications, mortality, success rate, and median survival time of patients before and after surgery were evaluated. Results: The median follow-up time was 40 months (range 4-61 months). All patients with symptoms of dyspnea have been significantly alleviated. Perioperative mortality was 0. The patient was well tolerated by this procedure and no apparent side effects were observed. In-hospital mortality was 2% and pleurodesis was successful at 85%. Poor KS scores and pleural effusion diagnosed to complete the delay between pleurodesis and hospital mortality was significantly correlated. The best survival of breast cancer, followed by ovarian cancer, lymphoma and pleural mesothelioma. Conclusions: Thoracoscopic talc pleurodesis is a safe and effective procedure. The success rate of pleurodesis is high, and breathing difficulties can be controlled effectively for a long time.