【摘要 】 目的 寻找通过外科手段治疗内科无法根治的复治耐多药菌阳重症空洞型肺结核的有效途径。方法 1981～1998年6月采用空洞清除术治疗复治耐药空洞型肺结核104例。切除覆盖在空洞外侧的肋骨后段，游离相应部位的带蒂肋间组织，剪除空洞外侧壁，彻底清除空洞内容物，刮出新鲜创面，有机酸杀灭可能残留的结核分支杆菌，将准备好的肋间肌瓣填充于空洞残腔内，缝合固定。结果 104例中出院时治愈103例(99.0%)，其中一次手术治愈101例(98.1%)，好转1例(1.0%)。随访98例中，复工率96%，无手术死亡和复发者。结论 空洞清除术设计合理，是治疗内科无法根治的复治菌阳空洞型肺结核的有效方法。

    

Changchun Tuberculosis Hospital, Changchun 130062

【Abstract 】 Objective Tostudy the effective surgical way for serious relapse multidrug resistant bacillarycavitary pulmonary tuberculosis. Methods 104 cases of serious relapse multidrugresistant bacillary cavitary pulmonary tuberculosis were cured by cleaning cavityoperation from 1981 to 1998. The operation contained resecting the back rib covering thecavity, separating the intercostal tissue, cutting the external wall of the cavity,cleaning the cavity thoroughly, scraping the cavity till exposing the fresh tissue,killing the tuberculosis germs with organic acid, filling the cavity with the intercostalmuscle, fixing and suturing the muscles. Results Among the 104 cases, 103 cases (99.0%)were cured, 101 cases (98.1%) were cured after the first operation, one case (1.0%) becamebetter. Among the 98 cases follwed up, the rate of returning to work were 96%, no one diedor relapsed. Conclusions The design of cleaning cavity operation is reasonable and it isthe effective method to treat the relapse bacillary cavitary pulmonary tuberculosis, therate of cure and sputum conversion are promising.

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