Respiratory Center, Ricardo Gutiérrez children's Hospital, Buenos Aires, Argentina.
Department of Thoracic Surgery, Ricardo Gutiérrez children's Hospital, Buenos Aires, Argentina.
Pediatr Pulmonol. 2019 May;54(5):525-530. doi: 10.1002/ppul.24255. Epub 2019 Jan 23.
Few studies have prospectively evaluated recovery process and long-term consequences of pleural space infections.
To evaluate clinical, pulmonary, and diaphragmatic function and radiological outcome in patients hospitalized with pleural empyema.
Previously healthy patients from 6 to 16 years were enrolled. Demographic, clinical, and treatment data were registered. At hospital discharge, and every 30 days or until normalization, patients underwent a clinical evaluation, diaphragmatic ultrasound, and lung function testing. Chest radiographs were performed at subsequent visits only if abnormalities persisted.
Thirty patients were included. Nineteen (63%) were male, with an age of (mean ± SD) 9.7 ± 3.2 years, and body mass index (mean ± SD) 18.6 ± 3. Twelve patients (40%) were treated with chest tube drainage only, 12 (40%) exclusively with surgery, and 6 (20%) completed treatment with surgery due to an ineffective chest tube drainage. At hospital discharge, 26 (87%) of patients had abnormal breath sounds at the site of infection, 28 (93%) had a spirometric restrictive pattern, 19 (63%) diaphragmatic motion impairment, and 29 (97%) presented radiological involvement of pleural space, mainly pleural thickening. All patients had recovered diaphragmatic motion and were asymptomatic at 90- and 120-day follow-up control, respectively. Then, with a great individual variability, radiological findings, and lung function returned to normal at 60 days (range 30-180) and 90 days (range 30-180) after hospital discharge, respectively.
Patients with pleural empyema had a complete and progressive recovery, with initial clinical and diaphragmatic motion normalization followed by radiological and lung function recovery.
很少有研究前瞻性地评估胸腔感染的恢复过程和长期后果。
评估因脓胸住院患者的临床、肺部和膈肌功能以及影像学结果。
招募了 6 至 16 岁的既往健康患者。登记了人口统计学、临床和治疗数据。在出院时以及每 30 天或直至恢复正常时，患者接受临床评估、膈肌超声和肺功能测试。只有在持续存在异常时，才在随后的就诊时进行胸部 X 线检查。
共纳入 30 名患者。19 名（63%）为男性，年龄（平均值±标准差）为 9.7±3.2 岁，体重指数（平均值±标准差）为 18.6±3.2。12 名（40%）患者仅接受胸腔引流管治疗，12 名（40%）患者仅接受手术治疗，6 名（20%）患者因胸腔引流管治疗无效而接受手术治疗。出院时，26 名（87%）患者感染部位呼吸音异常，28 名（93%）患者存在肺功能限制模式，19 名（63%）膈肌运动障碍，29 名（97%）患者存在胸腔空间的影像学受累，主要是胸腔增厚。所有患者在 90 天和 120 天的随访时分别恢复了膈肌运动，且无症状。然后，在个体差异很大的情况下，分别在出院后 60 天（范围 30-180）和 90 天（范围 30-180）时，影像学发现和肺功能恢复正常。
脓胸患者完全且逐渐恢复，最初表现为临床和膈肌运动正常，随后表现为影像学和肺功能恢复。
