Oki Tomonari, Funai Kazuhito, Sekihara Keigo, Shimizu Kei, Shiiya Norihiko
First Department of Surgery, Hamamatsu University School of Medicine,Hamamatsu, Japan.
Kyobu Geka. 2013 Aug;66(9):852-4.
The patient was a 68-year-old male. At the previous hospital, continuous hemodiafiltration (CHDF)was performed through internal jugular vein for diabetic nephropathy. Long term catheterisation caused the abscess of the sternoclavicular joint, which induced methicillin-resistant Staphylococcus aureus( MRSA) empyema. Endoscopic thoracic debridement was performed for the empyema, however inadequate drainage for the abscess. Thereafter, the patient transferred to our hospital. We performed adequate drainage for the abscess under general anesthesia at 5 days after hospitalization, and then open decortication for empyema at 26 days. The patient recovered well after operation and was discharged from the hospital at 46 days. This was a successful case of surgical treatment for refractory MRSA empyema, which controls all focus of infection.
该患者为68岁男性。在之前的医院，因糖尿病肾病通过颈内静脉进行了持续血液透析滤过（CHDF）治疗。长期置管导致胸锁关节脓肿，进而引发耐甲氧西林金黄色葡萄球菌（MRSA）脓胸。对脓胸进行了内镜下胸廓清创术，但脓肿引流不充分。此后，患者转至我院。住院5天后，我们在全身麻醉下对脓肿进行了充分引流，然后在26天时对脓胸进行了开放剥脱术。患者术后恢复良好，于46天时出院。这是一例成功治疗难治性MRSA脓胸的手术病例，控制了所有感染病灶。
