I. Surgical treatment of cavitary pulmonary tuberculosis.
Surgical indications
1.Patients with cavitary pulmonary tuberculosis who have been treated with anti-tuberculosis therapy for 18 months, but the cavity has not changed significantly or has thickened or increased in size, and the sputum is consistently positive for tuberculosis, especially those who are resistant to various anti-tuberculosis drugs.
2.Cavitary tuberculosis, especially thick-walled cavity, combined with recurrent hemoptysis or secondary infection, with obvious clinical symptoms and ineffective drug treatment.
3. Those who cannot exclude cancerous cavities.
Second, tuberculoma.
Indications for surgery
1.Tuberculosis tumor standardized anti-tuberculosis treatment for more than 12 months, positive sputum bacteria, combined with hemoptysis.
2.Tuberculosis tumor can not exclude malignant lesions.
3.The diameter of tuberculoma is greater than 3cm, and the tuberculoma is ineffective after standard anti-tuberculosis treatment, or the tuberculoma increases within a short period of time during standard anti-tuberculosis treatment, which can be used as relative indications for surgery.
3. Surgical treatment of tuberculosis hemoptysis.
Indications for surgery
1. The amount of hemoptysis exceeds 300ml at one time or the amount of hemoptysis is greater than 600ml in 24h, and the conservative treatment of internal medicine is ineffective.
2.Recurrent hemoptysis, who have had asphyxia, asphyxia aura or hypotension, shock.
3.The site of bleeding is clear.
4. Cardiopulmonary function and general condition can tolerate the surgery.
IV. Mediastinal lymph node tuberculosis.
Indications for surgery
1, compression or invasion of adjacent organs and organs and cause corresponding adverse reactions and symptoms, after regular anti-tuberculosis treatment, the lesion is not absorbed and continues to expand.
2.The lesion cannot be differentiated from other mediastinal lymph node disorders and no clear diagnosis can be made.
3.The lesion lymph nodes are larger than 3CM in diameter and have formed tuberculous abscess.
4. Those with pulmonary atelectasis and caseous pneumonia, which are not treated by internal medicine.
V. Surgical treatment of drug-resistant tuberculosis.
Surgical indications
1.Multidrug-resistant limited pulmonary tuberculosis, with more than 18 months of regular chemotherapy and positive sputum bacteria.
2.Multidrug-resistant tuberculosis with chronic fibrous cavity, abscess chest, bronchopleural fistula or one side of the destroyed lung without active lesions in the contralateral lung.
3.Multidrug-resistant tuberculosis with uncontrollable hemoptysis and recurrent pulmonary infections.
4, cardiopulmonary function and general condition can tolerate the surgery.
Sixth, tuberculosis-damaged lung.
Indications for surgery:
The lesion is located in one side of the lung, the regular anti-tuberculosis treatment is ineffective, and the lesion in the contralateral lung is stable. The duration of chemotherapy should be determined according to the drug resistance of the tuberculosis bacilli and the condition of the remaining lung after surgery, and four or more sensitive anti-tuberculosis drugs should be given for more than 12 months.
VII. Tuberculous abscess chest.
Indications for surgery.
1.Regulated anti-tuberculosis treatment for more than one year.
2.Pustular thorax has formed a clear boundary package.
3.No tuberculous lesions in the lung or the tuberculous lesions have been calcified and stabilized.