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目的 总结电视辅助胸腔镜手术(VATS)治疗胸部结核病变的临床经验,以提高VATS治疗胸部结核病变的治愈率.方法 2013年1月至2016年5月,广西壮族自治区龙潭医院胸外科对153例胸部结核患者根据手术的难易程度采用全电视胸腔镜手术(cVATS)技术或者电视胸腔镜辅助小切口(VAMT)技术进行治疗.153例患者中,肺结核47例,结核性脓胸100例,急性渗出性结核性心包炎6例;对本组患者采用的手术方式、患者的术后并发症及预后进行分析.结果 术中无死亡患者.47例肺结核患者采用cVATS技术进行肺楔形切除术30例;采用VAMT技术进行肺叶切除术12例,肺段切除术5例.100例结核性脓胸患者,采用cVATS技术进行脓胸引流术2例,脓胸廓清术70例,胸膜纤维板剥脱术16例;采用VAMT技术进行胸膜纤维板剥脱术10例;2例中途转为常规切口.6例急性渗出性结核性心包炎患者均采用cVATS技术进行心包开窗术.7例(4.6％,7/153)患者术后1个月内出现并发症;其中急性左心功能衰竭1例,心肺复苏无效死亡;窦性心动过速1例,肺持续漏气＞7 d3例,肺叶间裂积液2例,均经过相应处理后治愈.随访1～18个月,共计治愈130例(85.0％,130/153),无效1例(0.7％,1/153);22例仍处于随访中,痰菌均为阴性.结论 VATS治疗无明显粘连、病变部位局限的肺结核,纤维素期与机化初期的结核性脓胸,有心包填塞症状的急性渗出性结核性心包炎,可以取得较好的疗效.“,”Objective To summarize the experience of video-assisted thoracoscopic surgery (VATS) treatment for thoracic tuberculosis,in order to improve the cure rate.Methods From January 2013 to May 2016,153 appropriate patients with thoracic tuberculosis were selected to be treated with complete VATS (cVATS) or videoassisted mini-thoracotomy (VAMT).Of the 153 patients,47 were pulmonary tuberculosis,100 were tuberculous empyema and the other 6 were acute exudative tuberculous pericarditis.The operative methods,postoperative complications and prognosis were analyzed.Results There was no intraoperative death.Of the 47 pulmonary tuberculosis patients,30 were treated with wedge resection by cVATS,12 underwent lobectomy by VAMT and 5 were operated with segmentectomy by VAMT.Among 100 empyema cases,cVATS drainage were in 2 patients,cVATS debridement were in 70 patients,16 patients treated with cVATS decortication,10 patients underwent VAMT decortication and 2 case were converted to conventional thoracotomy.All the 6 patients with acute exudative tuberculous pericarditis were treated with pericardial window by cVATS.Postoperative complications occurred within 1 month in 7 cases (4.6％,7/153);of them,one was acute left heart failure and died,the cardio-pulmonary resuscitation was ineffective;one was sinus tachycardia,3 cases were with the air leak over 7 days and 2 cases were suffered interlobe effusion,all of them were cured after treatment.After 1-18-month follow-up,it was found that 130 cases (85.0％,130/153) were cured,1 case (0.7％,1/153) was ineffective,other 22 cases were still being followed up;all the sputum smear were negative.Conclusion VATS is suitable for treating pulmonary tuberculosis with no adhesion or mild adhesion,fibrinopurulent or early organized stage tuberculous empyema and acute exudative tuberculous pericarditis.