Vallières Eric
Department of Surgery, Division of Cardiothoracic Surgery, University of Washington Medical Center, 1959 NE Pacific Street, Box 356310, Seattle, WA 98195-3610, USA.
Chest Surg Clin N Am. 2002 Aug;12(3):571-85. doi: 10.1016/s1052-3359(02)00019-4.
Empyemas that complicate lung resection are an uncommon but morbid and too-often deadly sequela, particularly after pneumonectomy. Knowledge of the conditions that place patients at high risk for this complication and of the well-established principles of bronchial stump closure are crucial to preventing empyemas. One should be familiar with the various options of stump reinforcement and should use them aggressively, particularly in high-risk situations. Prompt recognition of this complication demands immediate intervention and drainage of the empyema space to minimize the risks of aspiration to the remaining lung. The principles that guide the management of these empyemas are those established by Clagett and Geraci 40 years ago [37]. Modern variations of these guidelines have allowed improved results and a more timely recovery and should be considered in low-risk patients.
肺切除术后并发的脓胸虽不常见，但却是一种严重且往往致命的后遗症，尤其是在全肺切除术后。了解哪些情况会使患者发生这种并发症的风险增高，以及熟知支气管残端闭合的既定原则，对于预防脓胸至关重要。医生应熟悉残端加固的各种方法，并积极应用，尤其是在高风险情况下。迅速识别这种并发症需要立即干预并引流脓腔，以将对剩余肺组织的误吸风险降至最低。指导这些脓胸治疗的原则是40年前克拉杰特（Clagett）和杰拉奇（Geraci）确立的原则[37]。这些指南的现代变体已带来了更好的治疗效果和更及时的康复，低风险患者应予以考虑。
