Division of Pulmonary and Sleep Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Respiration. 2011;82(2):193-6. doi: 10.1159/000326337. Epub 2011 Apr 7.
Parapneumonic effusions or empyemas are frequently seen in patients with lower respiratory tract infections. The condition is associated with significant morbidity and mortality. Since Gram stains and bacterial cultures are usually negative, treatment focuses on empiric antibiotic treatment and chest tube drainage. The role of intrapleural fibrinolytics is still a matter of debate. Medical thoracoscopy is a simple and effective therapeutic alternative associated with better outcome and fewer complications than conservative treatment. Furthermore, it can be performed in analgo-sedation in a bronchoscopy suite. Video-assisted thoracic surgery carries the advantage of providing optimal visibility of the pleural cavity, thus allowing better debridement. Thoracotomy is the treatment of choice when thoracoscopic cleaning is not satisfactory.
肺炎旁胸腔积液或脓胸常见于下呼吸道感染患者。这种情况与较高的发病率和死亡率相关。由于革兰氏染色和细菌培养通常为阴性，因此治疗侧重于经验性抗生素治疗和胸腔引流管。胸腔内纤维蛋白溶解剂的作用仍存在争议。内科胸腔镜检查是一种简单有效的治疗选择，与保守治疗相比，其结果更好，并发症更少。此外，它可以在支气管镜检查室内进行镇痛镇静下完成。电视辅助胸腔镜手术的优点是可以提供更好的胸腔可视性，从而可以更好地清创。当胸腔镜清洗不满意时，开胸手术是首选治疗方法。
