Preliminary Study On The Timing Of Operation For Tuberculous Empyema Thoracoscopic Assisted Fiberboard Stripping

Objective To study tuberculous empyema and analyze the indications for the operation of thoracoscopy-assisted tuberculous empyema fiberboard ablation surgery;to explore the choice of surgical timing for tuberculous empyema when using thoracoscopy fiberglass ablation surgery.Method Included in the tuberculosis empyema patients of Xinjiang people’s Hospital from January 2011 to January 2018,select appropriate patients according to the inclusion criteria and exclusion criteria,collect clinical data of patients,Including:patient’s gender,age(years),ethnicity,duration of disease(with 6 weeks as the limit,counting from the first symptoms of tuberculosis),disease-related symptoms(chest pain,cough,fever,fatigue,hemoptysis,night sweats,Weight loss),smoking history,past history(whether history of hypertension,history of tuberculosis,history of heart disease,history of diabetes,family history of cancer,etc.).At the same time,pay attention to the collection of imaging data,Complete chest CT scan range including the entire lung field.All scanned images were carefully analyzed by the physicians of the Radiological Imaging Center of the People’s Hospital of the Autonomous Region,mainly determine the pleural thickness(with 1cm as the boundary,divide patients into 2 groups according to pleural thickness,respectively <1cm and ≥1cm),and whether there are nodules in the lung.Collecting serological data of patients,Including full blood count(five classifications)+ C-reactive protein,blood biochemical indexes,Tuberculous infection of cells spot(T-Spot),tumor markers and Erythrocyte sedimentation rate.Pay attention to collecting pathological data,Extraction of pleural effusion or tissue by thoracentesis,Or after VATS resection,the specimens were sent to the pathology department of our hospital to complete the pathological examination.At the same time,the pleural effusion or tissues extracted by puncture and the postoperative specimens were stained with acid-fast staining.According to the results of pathology and acid-fast staining,the disease type was determined to be consistent with tuberculous empyema.These patients were treated with video-assisted thoracoscopic surgery(VATS)fiberboard ablation.Result VATS was performed in 43 patients with a course of less than 3 months,Compared with 21 patients who had VATS when the course of disease was more than or equal to 3 months,Low intraoperative blood loss,The time of drainage tube placement and postoperative drainage volume were less.However,there was no statistical difference in the operation duration between the two groups(P > 0.05).Compared with25 cases with pleura ≥1cm,39 cases with pleural thickness <1cm have Short operation time,Low intraoperative blood loss,The time of drainage tube placement and postoperative drainage volume were less.All the differences were statistically significant(P < 0.05).In 10 patients with pulmonary nodules,The amount of bleeding during operation and the time of placing drainage tube after operation were higher than those without pulmonary nodule,All the differences were statistically significant(P < 0.05).Conclusion To sum up,for tuberculous empyema patients,VATS fibreboard stripping can achieve better results when the course of disease is less than 3 months,the thickness of pleura is less than 1 cm,and there is no nodule in the lung.