非血管干预放射技术与视频辅助胸腔镜手术在II-III阶段的empyema:一个回顾性队列研究
Yoshio Nakano1, Masahisa Nakamura2, Iwao Gohma1
1Department of Respiratory Medicine, Sakai City Medical Center, 1-1-1, Ebaraji-cho, West Ward, Sakai City, Osaka Prefecture, 593-8304, Japan.
Respiratory investigation
|December 30, 2025
概括
干预性放射学 (IR) 为II-III阶段 empyema提供了视频辅助胸腔镜手术 (VATS) 的最小侵入性替代方案. 虽然VATS的初始成功率更高,但IR和VATS的整体结果相似,IR患者年龄较大.
科学领域:
- 胸部外科手术 胸部外科手术
- 干预性放射学 干预性放射学
- 肺部医学 肺部医学
背景情况:
- 肺管理通常涉及手术,如视频辅助胸腔镜手术 (VATS).
- 最少侵入性干预性放射学 (IR) 技术,包括水解剖和导线解剖,提供了潜在的替代方案.
- 本研究将IR和VATS进行比较,用于治疗II-III阶段的血瘤.
研究的目的:
- 为了比较干预性放射学 (IR) 与视频辅助胸腔镜手术 (VATS) 的临床结果,用于II-III阶段的瘤.
- 评估两种治疗方式之间的治疗成功率,整体临床结果和患者人口统计数据.
- 为了评估IR的安全性和有效性,作为对empyema管理的一种不那么侵入性的选择.
主要方法:
- 从2021年4月到2024年10月,对45名患有II-III阶段瘤 (IR:n=23,VATS:n=22) 的患者进行了回顾性分析.
- 主要治疗成功定义为没有转换为手术的解决方案;重复的IR程序在IR策略中计算.
- 使用适当的测试进行统计比较,显著程度为p < 0.05.
主要成果:
- 初级治疗成功率为IR的87.0%,而VATS的100% (p=0.233).
- 总体临床结果为IR的95.6%和VATS的100% (p=1).
- IR患者年龄较大 (中位数为78.0与71.5岁,p=0.046) 性能状况较差 (p=0.015),但没有观察到住院时间,排水时间或抗生素治疗的显著差异.
结论:
- 在这个队列中,对于II-III阶段的empyema,基于IR的管理和VATS之间的总体结果没有统计学上显著的差异.
- 尽管IR组中老年患者的比例较高,但IR组的表现状况较差,但IR显示了与VATS可比的整体疗效.
- 进一步的研究可能会探索IR在特定患者群体中对empyema的作用.
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