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一百例脓胸病例回顾。

Review of one hundred cases of empyema thoracis.

作者信息

Gupta S K, Kishan J, Singh S P

出版信息

Indian J Chest Dis Allied Sci. 1989 Jan-Mar;31(1):15-20.

PMID:2680931
Abstract

One hundred cases of empyema thoracic have been reviewed. Aetiology of empyema was tubercular in 21 per cent cases and non-tubercular in 79 per cent cases. Gram negative organisms were cultured in 84.6% cases, whereas gram positive organisms were cultured only in 15.4% cases. It was observed that management of cases of empyema differed considerably with the presence or absence of BPF, thick or thin pus and size of empyema. It was concluded that all cases of simple empyema with thin pus and only those cases of simple empyema with thick pus where size of empyema is small should be managed by aspiration/s. Cases failed by above method, all cases of simple empyema with thick pus and with moderate to large size of empyema and all cases of empyema with BPF should be straightway managed by intercostal drainage tube connected to water seal. On the whole, cases of empyema with BPF were difficult to manage and needed major surgery in 45.8 per cent cases in comparison to only 2.9 per cent cases of simple empyema.

摘要

对100例脓胸病例进行了回顾性研究。脓胸的病因在21%的病例中为结核性,79%的病例为非结核性。84.6%的病例培养出革兰氏阴性菌,而仅15.4%的病例培养出革兰氏阳性菌。观察到,脓胸病例的处理因是否存在支气管胸膜瘘、脓液浓稠或稀薄以及脓胸大小而有很大差异。得出的结论是,所有单纯性稀薄脓液脓胸病例以及仅那些单纯性浓稠脓液且脓胸较小的脓胸病例应通过抽吸进行处理。上述方法失败的病例、所有单纯性浓稠脓液且脓胸为中度至大尺寸的病例以及所有伴有支气管胸膜瘘的脓胸病例应直接通过连接水封的肋间引流管进行处理。总体而言,伴有支气管胸膜瘘的脓胸病例难以处理,45.8%的此类病例需要进行大手术,而单纯性脓胸病例仅2.9%需要进行大手术。

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