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非COVID-19急性呼吸窘迫综合征后合并COVID-19肺炎时的肺切除术后脓胸

Postpneumonectomy Empyema in the Presence of COVID-19 Pneumonia after Non-COVID-19 ARDS.

作者信息

Leneis Veronika, Nemeth Attila, Schlensak Christian, Steger Volker

机构信息

Department of Thoracic and Cardiovascular surgery, Faculty of medicine, Clinic of university, Eberhard-Karls-University Tuebingen, Tuebingen, Baden-Württemberg, Germany.

Department of Thoracic and Cardiovascular Surgery, Clinic of University, Tuebingen, Baden Württemberg, Germany.

出版信息

Thorac Cardiovasc Surg Rep. 2023 Aug 3;12(1):e51-e53. doi: 10.1055/s-0043-1771197. eCollection 2023 Jan.

Abstract

Development of pleural empyema with or without bronchopleural fistula following pneumonectomy presents a major complication with a mortality of 10 to 20%. The surgical goals of bronchopleural fistula treatment are infection control, pus drainage, and lung re-expansion. The main goal is closure of the fistula. This can be achieved with various surgical methods, such as the Clagett or accelerated Weder procedure, omentoplasty, or a transpericardial approach, according to Abruzzini. We present the case of a 58-year-old patient with pleural empyema within the postpneumonectomy cavity in the presence of severe COVID-19 pneumonia after non-COVID-19 acute respiratory distress syndrome (ARDS) and extracorporeal membrane oxygenation (ECMO) therapy. The patient had undergone right-sided pneumonectomy for destroyed lung syndrome after invasive pulmonary aspergillosis.

摘要

肺切除术后并发或不并发支气管胸膜瘘的脓胸是一种主要并发症,死亡率为10%至20%。支气管胸膜瘘治疗的手术目标是控制感染、引流脓液和使肺复张。主要目标是闭合瘘口。根据阿布鲁齐尼的说法,这可以通过各种手术方法实现,如克拉格特手术或加速韦德尔手术、网膜成形术或经心包途径。我们报告一例58岁患者的病例,该患者在非COVID-19急性呼吸窘迫综合征(ARDS)和体外膜肺氧合(ECMO)治疗后,因严重COVID-19肺炎,在肺切除术后的胸腔内发生脓胸。该患者因侵袭性肺曲霉病导致肺毁损综合征接受了右侧肺切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0941/10411203/d2ab47d4fa65/10-1055-s-0043-1771197-i1120220455crt-1.jpg

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