脓胸患者的手术结果与术前胸部增强计算机断层扫描（CECT）胸廓形态测量的特殊相关性
Surgical outcome of empyema thoracis patients with special correlation to pre-operative contrast-enhanced computerized tomography (CECT) thorax morphometry.
作者信息
Das Narendra Nath, Lakhotia Siddharth, Verma Ashish
机构信息
Department of CTVS, Institute of Medical Sciences, BHU, Varanasi, India.
Department of Radio Diagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi, India.
出版信息
Indian J Thorac Cardiovasc Surg. 2021 Mar;37(2):164-174. doi: 10.1007/s12055-020-01053-5. Epub 2020 Oct 15.
PURPOSE
Empyema thoracis is a very common disease. The surgical outcome of empyema patients depends upon various factors. To the best of our knowledge, there is no study in literature describing the surgical outcome of patients in relation to the contrast-enhanced computerized tomography (CECT) thorax morphometric findings. In this study, we examined the surgical outcome of empyema thoracis patients in relation to both clinical and radiological findings.
MATERIALS AND METHODS
It is a prospective hospital-based study conducted between October 2016 and August 2018. A total of 30 patients, who underwent decortication during the study period, were included. They were divided into three performance groups (excellent performance, average performance and poor performance groups) according to the outcome. The surgical outcome was correlated with the pre-operative clinical, radiological, intra-operative and post-operative parameters.
RESULTS
Intra-operative ability to complete decortication, intra-operative expansion of the lungs and presence of broncho-pleural fistula were significantly different between the three performance groups. Duration of the disease, pre-operative duration of antitubercular therapy (ATT) intake and duration of pre-operative intercostal drain (ICD) were statistically insignificant between groups. In computed tomography (CT) morphometry, residual lung volume of the involved lung and volume of empyema were found to be significantly different between the performance groups. The residual volume of the involved lung (expressed in terms of the percentage of lung volume of the normal opposite lung) can predict the complete expansion of the lung with sensitivity of 71% and specificity of 70%.
CONCLUSION
The pre-operative residual lung volume of the involved lung, empyema volume, completeness of decortication, intra-operative expansion of the lung and presence or absence of broncho-pleural fistula can determine the surgical outcome in empyema thoracis patients.
目的
脓胸是一种非常常见的疾病。脓胸患者的手术结果取决于多种因素。据我们所知，文献中尚无关于脓胸患者手术结果与胸部增强计算机断层扫描（CECT）形态学表现关系的研究。在本研究中，我们研究了脓胸患者的手术结果与临床及影像学表现的关系。
材料与方法
这是一项于2016年10月至2018年8月在医院进行的前瞻性研究。纳入了在研究期间接受纤维板剥脱术的30例患者。根据结果将他们分为三个表现组（优秀表现组、中等表现组和差表现组）。将手术结果与术前临床、影像学、术中及术后参数进行相关性分析。
结果
三个表现组在术中完成纤维板剥脱的能力、术中肺扩张情况及支气管胸膜瘘的存在情况方面存在显著差异。疾病持续时间、术前抗结核治疗（ATT）持续时间和术前肋间引流（ICD）持续时间在各组之间无统计学意义。在计算机断层扫描（CT）形态学方面，各表现组受累肺的残余肺体积和脓胸体积存在显著差异。受累肺的残余体积（以对侧正常肺体积的百分比表示）可预测肺的完全扩张，敏感性为71%，特异性为70%。
结论
受累肺的术前残余肺体积、脓胸体积、纤维板剥脱的完整性、术中肺扩张情况以及支气管胸膜瘘的有无可决定脓胸患者的手术结果。
Zotero 插件