Kaneko Tadashi
Department of Surgery, Kinki Central Hospital, Itami, Japan.
Kyobu Geka. 2005 Jul;58(8 Suppl):718-23.
We shall consider carefully for surgical management of pleural empyema in elderly patients over 80 years old for the reason that their preoperative conditions are frequently poor, due to such as several complications, low activity of dayly life and immunodeficiency on account of undernutrition. Sufficiently drainage and cleaning the abscess cavity by irrigation of saline with antibiotics through chest tube are required in acute period of empyema. In chronic period of empyema, prolonged hospitalization because of unsucusessful drainage, surgical management is necessary. Various surgical procedures reported by many authors were reviewd and suitable method should be selected respectively, taking individual states of elderly patients into consideration.
对于80岁以上的老年患者，我们应仔细考虑胸膜腔积脓的手术治疗，因为他们术前状况往往较差，原因包括多种并发症、日常生活活动能力低以及由于营养不良导致的免疫缺陷。在脓胸急性期，需要通过胸管灌注含抗生素的生理盐水充分引流并清洁脓腔。在脓胸慢性期，由于引流不成功导致住院时间延长，手术治疗是必要的。我们回顾了许多作者报道的各种手术方法，并应考虑老年患者的个体状况分别选择合适的方法。
