Bai K J, Wu I H, Yu M C, Chiang I H, Chiang C Y, Lin T P, Lee Y C, Luh K T
Department of Clinical Service, Taiwan Provincial Chronic Disease Control Bureau, Taipei.
Respirology. 1998 Dec;3(4):261-6. doi: 10.1111/j.1440-1843.1998.tb00132.x.
The clinical courses of 35 tuberculous empyema patients were investigated retrospectively from November 1990 through November 1995. Most patients had nonspecific symptoms and signs but with far-advanced pulmonary parenchymal lesions in their chest roentgenographs. The effusions showed neutrophilic leukocytosis with a 60% positive culture rate for Mycobacterium tuberculosis. Multidrug resistant strains were found in 7 out of 18 cultures. All patients received chemotherapy and eight of them underwent additional surgical management. Twenty-two (62.9%) patients had been treated successfully and one patient is still under treatment. The remaining 12 patients either died during treatment or defaulted; and four (11.4%) of them had died of tuberculosis. We conclude that the treatment outcome of tuberculous empyema is less satisfactory than that of pulmonary tuberculosis, however, modern multidrug chemotherapy with repeated drainage and opportune surgical interventions could be in prospect of successful treatment of tuberculous empyema.
对1990年11月至1995年11月期间35例结核性脓胸患者的临床病程进行了回顾性研究。大多数患者有非特异性症状和体征，但胸部X线片显示肺部实质病变已至晚期。胸腔积液显示中性粒细胞增多，结核分枝杆菌培养阳性率为60%。18份培养物中有7份发现耐多药菌株。所有患者均接受了化疗，其中8例还接受了额外的手术治疗。22例（62.9%）患者治疗成功，1例仍在治疗中。其余12例患者在治疗期间死亡或失访；其中4例（11.4%）死于结核病。我们得出结论，结核性脓胸的治疗效果不如肺结核，但现代多药化疗联合反复引流和适时的手术干预有望成功治疗结核性脓胸。
