Abraham Sujith Varghese, Chikkahonnaiah Prashant
Department of Pulmonary Medicine, Mysore Medical College and Research Institute, Mysuru, India.
Turk Thorac J. 2020 Jan;21(1):27-31. doi: 10.5152/TurkThoracJ.2019.180146. Epub 2020 Jan 1.
Chronic empyema is the final stage of the triphasic pathogenesis of empyema that is characterized by fibrin deposits in both pleural surfaces, leading to the formation of a thickened pleural peel. This restricts the lung movements, giving rise to a trapped lung and impairment of pulmonary function. The aim of this study was to determine the change in pulmonary function following decortication for chronic empyema.
A total of 35 patients with chronic pleural empyema who underwent decortication via a posterolateral thoracotomy between July 2016 and July 2017 were reviewed and followed-up for 6±3 months after surgery. All patients underwent a pulmonary function test using spirometry before and after surgery. Pre-operation spirometry values [mean forced expiratory volume in 1s (FEV) and mean forced vital capacity (FVC)] were compared with the post-operation data obtained during follow-up and the change was quantified by statistical analysis.
FEV was 70.51% before surgery vs. 83.43% after surgery (p<0.001). FVC was 69.74% before surgery vs. 85.40% after surgery (p<0.001). There was no influence of bacteriology, side of occurrence of the lesion, smoking habit, or diabetes mellitus present before the operation on the patients' lung function (p>0.01).
Decortication and pleurectomy via a posterolateral thoracotomy resulted in significant clinico-functional improvement in patients with chronic empyema, regardless of the bacteriology, side of occurrence of the lesion, smoking habit, or diabetic status of the patient.
慢性脓胸是脓胸三相发病机制的最后阶段,其特征是胸膜两面有纤维蛋白沉积,导致形成增厚的胸膜纤维板。这限制了肺的活动,导致肺被束缚和肺功能受损。本研究的目的是确定慢性脓胸行胸膜纤维板剥脱术后肺功能的变化。
回顾性分析2016年7月至2017年7月期间通过后外侧开胸行胸膜纤维板剥脱术的35例慢性胸膜脓胸患者,并在术后进行6±3个月的随访。所有患者在手术前后均使用肺活量计进行肺功能测试。将术前肺活量计测量值[1秒用力呼气量(FEV)平均值和用力肺活量(FVC)平均值]与随访期间获得的术后数据进行比较,并通过统计分析对变化进行量化。
术前FEV为70.51%,术后为83.43%(p<0.001)。术前FVC为69.74%,术后为85.40%(p<0.001)。术前的细菌学、病变发生侧、吸烟习惯或糖尿病对患者的肺功能没有影响(p>0.01)。
后外侧开胸行胸膜纤维板剥脱术和胸膜切除术可使慢性脓胸患者在临床功能上得到显著改善,无论患者的细菌学情况、病变发生侧、吸烟习惯或糖尿病状态如何。