Kacprzak Grzegorz, Marciniak Marek, Kołodziej Jerzy, Addae Emmanuel
Wrocławski Ośrodek Torakochirurgii: Klinika Chirurgii Klatki Piersiowej AM, Oddział Torakochirurgii Dolnoślaskiego Centrum Chorób Płuc.
Pneumonol Alergol Pol. 2003;71(1-2):24-30.
Between 1984 and 2000 in the Thoracic Surgery Centre pneumonectomies were performed in 947 patients. Postpneumonectomy empyema (PE) occurred in 67 (7%) patients. The aim of this paper were: analysis the reasons of postpneumonectomy empyema appearance, defined bacterial flora, clinical course and optimal management. The causes of PE were: pleural cavity haematoma (20 patients-29.8%), wound suppuration (18 patients-26.8%), bronchial fistula (31 patients-46.2%). These complications appeared singly or together in 49 (73.1%) patients. In 2 (3.0%) patients a long treatment in the Intensive Care Unit because of postoperative shock was the cause of infection. In 3 (4.5%) cases the cause of empyema was associated with infection during the operation. In 13(19.4%) cases the cause of empyema was not established. In 55 patients infections of pleural cavities were diagnosed in the first 8 weeks after operations. In 12 patients empyemas were established later. 12 (17.9%) patients died during the analyzed 1 year period after operation. In 18 (26.9%) patients infections were caused by only one bacterial strain and in 49 (73.1%) by two or three bacterial strains. The different methods of treatment (thoracentesis, drainage, operation) depending on general condition of patient were done.
1984年至2000年间，胸外科中心对947例患者实施了肺切除术。67例（7%）患者发生了肺切除术后脓胸（PE）。本文的目的是：分析肺切除术后脓胸出现的原因，确定细菌菌群、临床病程及最佳治疗方法。PE的病因包括：胸腔血肿（20例，占29.8%）、伤口化脓（18例，占26.8%）、支气管瘘（31例，占46.2%）。这些并发症单独或共同出现在49例（73.1%）患者中。2例（3.0%）患者因术后休克在重症监护病房接受了长时间治疗，这是感染的原因。3例（4.5%）病例中，脓胸的病因与手术期间的感染有关。13例（19.4%）病例中，脓胸的病因未明确。55例患者在术后前8周被诊断出胸腔感染。12例患者的脓胸诊断较晚。12例（17.9%）患者在术后分析的1年期间死亡。18例（26.9%）患者的感染仅由一种细菌菌株引起，49例（73.1%）患者的感染由两种或三种细菌菌株引起。根据患者的一般状况采用了不同的治疗方法（胸腔穿刺、引流、手术）。
