真空辅助治疗持续性肺叶切除术后脓胸：9例患者分析

Treatment of persistent postpneumonectomy empyema by vacuum-assisted management: an analysis of nine patients.

作者信息

Celik Ali, Yekeler Erdal, Aydın Ertan, Yazıcı Ulku, Karaoglanoglu Nurettin

机构信息

Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Keçiören, Ankara, Turkey.

出版信息

Thorac Cardiovasc Surg. 2013 Oct;61(7):631-5. doi: 10.1055/s-0032-1331263. Epub 2012 Dec 6.

DOI:10.1055/s-0032-1331263

PMID:23225510

Abstract

BACKGROUND

Conventional treatment methods in postpneumonectomy empyemas (PPE) are associated with long stay in hospital, poor patient comfort, and high rate of postoperative mortality. Vacuum-assisted management (VAM) may be helpful in solving these problems.

METHODS

VAM was performed on nine patients with PPE in our clinic between July 2010 and September 2011 to provide continuous drainage of empyema in the pouch and to improve empyema with obliteration of the pouch by accelerating tissue granulation.

RESULTS

All nine patients were men (mean age: 54.5 years; range: 18-68 years). Empyema resolution and obliteration of the pouch were achieved with VAM in the cases with empyema without fistula (n = 7) after the pneumonectomy. In the patients with fistula (n = 2), VAM was performed after closure of the fistula. Mean duration of hospital stay was 36.5 (12-57) days. The treatment was successful in eight of nine patients (88.9%). Mean duration of follow-up in the successfully treated patients was 10.9 (3-17) months.

CONCLUSION

Intrathoracic VAM was effective and safe in the treatment of PPE.

摘要

背景

肺切除术后脓胸（PPE）的传统治疗方法与住院时间长、患者舒适度差及术后死亡率高相关。真空辅助治疗（VAM）可能有助于解决这些问题。

方法

2010年7月至2011年9月期间，我们诊所对9例PPE患者实施了VAM，以持续引流脓腔积脓，并通过加速组织肉芽形成来改善脓腔并使其闭塞。

结果

所有9例患者均为男性（平均年龄：54.5岁；范围：18 - 68岁）。肺切除术后无瘘管的脓胸患者（n = 7）通过VAM实现了脓腔消退和脓腔闭塞。对于有瘘管的患者（n = 2），在瘘管闭合后实施了VAM。平均住院时间为36.5（12 - 57）天。9例患者中有8例（88.9%）治疗成功。成功治疗患者的平均随访时间为10.9（3 - 17）个月。