Levinson Gary M, Pennington Daniel W
Mercy Medical Center of North Iowa, 1000 4th St SW, Mason City, IA 50401, USA.
Mayo Clin Proc. 2007 Apr;82(4):407-13. doi: 10.4065/82.4.407.
To present our method of treating pleural infection by using a combination of image-guided chest tube drainage and intrapleural fibrinolytics.
We retrospectively reviewed the medical charts and radiographs of 30 consecutive patients with pleural infection who were seen at our institution from December 15, 1995, to July 1, 2006, 27 of whom received intrapleural urokinase or tissue-type plasminogen activator. End points were death, length of stay in the hospital, and percentage of patients who needed surgery.
Placement of chest tubes required image guidance 45.7% of the time. Three patients (10%; 95% confidence interval, 2.1%-26.5%) died of complications from pleural infection. None of the 30 patients (0%; 95% confidence interval, 0%-9.5%) required surgery for treatment of pleural infection. The median hospital length of stay was 11 days.
In the treatment of pleural infection, intrapleural urokinase or tissue-type plasminogen activator in combination with careful image-guided placement of chest tubes is highly effective in resolving the effusion and curing the infection.
介绍我们采用影像引导下胸腔置管引流联合胸腔内使用纤维蛋白溶解剂治疗胸腔感染的方法。
我们回顾性分析了1995年12月15日至2006年7月1日在我院就诊的30例连续性胸腔感染患者的病历和X光片，其中27例接受了胸腔内尿激酶或组织型纤溶酶原激活剂治疗。观察终点为死亡、住院时间及需要手术治疗的患者比例。
45.7%的胸腔置管操作需要影像引导。3例患者（10%；95%置信区间，2.1%-26.5%）死于胸腔感染并发症。30例患者中无一例（0%；95%置信区间，0%-9.5%）因胸腔感染需要手术治疗。中位住院时间为11天。
在胸腔感染的治疗中，胸腔内使用尿激酶或组织型纤溶酶原激活剂并结合影像引导下仔细放置胸腔引流管，在消除胸腔积液和治愈感染方面非常有效。
