Smith J A, Mullerworth M H, Westlake G W, Tatoulis J
Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Ann Thorac Surg. 1991 Jan;51(1):39-42. doi: 10.1016/0003-4975(91)90443-t.
One hundred two patients with empyema thoracis were managed at the Royal Melbourne Hospital between 1976 and 1989. Fifty-five cases of empyema thoracis were postpneumonic, 8 followed esophageal rupture, and 5 were associated with thoracic trauma. Some form of systemic illness was a major contributing factor in the presentation of 29 patients. A single causal organism was found in 53 patients (the most common being Staphylococcus aureus), multiple organisms in 36, and no growth in 13. During the years 1983 to 1989 there was an increased incidence of empyemas caused by multiple or antibiotic-resistant organisms. Operative drainage was required in 90 patients and 12 were managed by thoracentesis or intercostal tube drainage alone. The in-hospital mortality rate for patients managed nonoperatively was 58% (7 of 12 patients); it was 16% (14 of 90 patients) for those receiving operative drainage. There were seven late deaths, four empyema related and three nonrelated. Early adequate operative drainage is recommended for patients with empyema thoracis.
1976年至1989年间，皇家墨尔本医院收治了102例脓胸患者。其中55例脓胸为肺炎后所致，8例继发于食管破裂，5例与胸部创伤有关。29例患者发病的主要促成因素为某种形式的全身性疾病。53例患者发现单一病原体（最常见的是金黄色葡萄球菌），36例为多种病原体，13例未培养出细菌。1983年至1989年期间，由多种或耐药病原体引起的脓胸发病率有所增加。90例患者需要手术引流，12例仅通过胸腔穿刺或肋间置管引流进行治疗。非手术治疗患者的院内死亡率为58%（12例患者中有7例）；接受手术引流的患者死亡率为16%（90例患者中有14例）。有7例晚期死亡，4例与脓胸相关，3例无关。建议对脓胸患者尽早进行充分的手术引流。
