Harada A, Nakamura Y, Fukumori K, Nagata T, Iguro Y
Department of Thoracic and Cardiovascular Surgery, Hepato-Biliary-Pancreatic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Kyobu Geka. 2010 Nov;63(12):1039-43.
We report a case for whom negative pressure wound therapy (NPWT) was applied for empyema with bronchopleural fistula. The patient was a 64-year-old man with a history of gastric resection and diabetes visited our hospital with chief complaints of fever and respiratory failure. In spite of conservative treatment after being diagnosed as empyema, bronchopleural fistula developed. In order to manage the pyothorax, the bronchopleural fistula was closed with endobronchial Watanabe spigot, and fenestration was subsequently performed, however the infection control and obliteration of the empyema cavity could not be achieved. NPWT with continuous irrigation was therefore chosen, and the methicillin-resistant Staphylococcus aureus (MRSA) disappeared and a marked obliteration of the empyema cavity was observed in 3 weeks after initiation of NPWT. Although the patient died of another illness, NPWT with continuous irrigation was useful in treating empyema with bronchopleural fistula.
我们报告了一例应用负压伤口治疗(NPWT)治疗合并支气管胸膜瘘的脓胸患者。该患者为一名64岁男性,有胃切除术史和糖尿病史,因发热和呼吸衰竭为主诉前来我院就诊。尽管诊断为脓胸后进行了保守治疗,但仍出现了支气管胸膜瘘。为了处理脓胸,采用支气管内渡边栓子封闭支气管胸膜瘘,随后进行开窗引流,但仍无法控制感染和消除脓腔。因此选择了持续冲洗的NPWT,耐甲氧西林金黄色葡萄球菌(MRSA)消失,在开始NPWT后3周观察到脓腔明显缩小。尽管患者死于其他疾病,但持续冲洗的NPWT对治疗合并支气管胸膜瘘的脓胸是有效的。