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[使用免疫调节剂和低频超声预防术后急性胸腔脓胸]

[Use of immunomodulators and low-frequency ultrasonics for prevention of acute postoperative pleural empyema].

作者信息

Uspenskiĭ L V, Belokrinitskiĭ D V, Chistov L V, Ablitsov Iu A, Pavlov Iu V

出版信息

Khirurgiia (Mosk). 1991 Oct(10):86-90.

PMID:1803101
Abstract

Many methods for the prevention of acute postoperative pyothorax have been suggested, but no tendency towards a reduction of its frequency has been noted in the recent years. A group of 100 patients with various diseases of the lungs (malignant tumors, abscesses, bronchiectases) was examined. They were divided into 3 groups according to the degree of the risk of development of acute postoperative pyothorax: with increased, moderate, and high risk. The first group consisted of 20 patients who were given small doses of immunomodulators Dibazole and Dekaris in the pre- and postoperative periods. Control of the immunity indices was conducted in the preoperative period and on days 14 and 21 after the operation. Intraoperative treatment of the pleura with low-frequency ultrasound was applied in the second group of 40 patients. Fourty patients of the third group were treated by a complex of both of the above-mentioned preventive methods. The control group was made up of 347 patients with a similar condition but not treated by the special methods of prevention. All of the 447 patients underwent radical operations. Analysis of the results of the study showed that acute postoperative pyothorax developed in 8.65% of patients in the control group in which immunoprophylaxis and intraoperative treatment of the pleura with low-frequency ultrasound were not applied. Acute postoperative pyothorax developed in 1% of cases in the main group.

摘要

已经提出了许多预防术后急性脓胸的方法,但近年来并未发现其发生率有下降的趋势。对一组100例患有各种肺部疾病(恶性肿瘤、脓肿、支气管扩张)的患者进行了检查。根据术后发生急性脓胸的风险程度,将他们分为3组:风险增加组、中度风险组和高风险组。第一组由20例患者组成,他们在术前和术后均接受小剂量免疫调节剂地巴唑和多抗甲素的治疗。在术前以及术后第14天和第21天对免疫指标进行了监测。第二组40例患者在术中采用低频超声对胸膜进行治疗。第三组40例患者采用上述两种预防方法进行综合治疗。对照组由347例病情相似但未采用特殊预防方法治疗的患者组成。所有447例患者均接受了根治性手术。研究结果分析表明,未采用免疫预防和术中低频超声胸膜治疗的对照组中,8.65%的患者发生了术后急性脓胸。主要治疗组中1%的病例发生了术后急性脓胸。

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