Mohamad Jailaini Mas Fazlin, Saini Noor Amirah, Che Rahim Mohd Jazman, Abdul Hamid Mohamed Faisal
Respiratory Unit, Faculty of Medicine Universiti Kebangsaan Malaysia (UKM) Kuala Lumpur Malaysia.
Respiratory Unit, Faculty of Medicine Universiti Sains Malaysia (USM) Kota Bharu Malaysia.
Respirol Case Rep. 2024 Aug 10;12(8):e70000. doi: 10.1002/rcr2.70000. eCollection 2024 Aug.
The treatment for empyema thoracis has been evolving over the years, including the usage of intrapleural fibrinolytic therapy (IPFT), for example, alteplase with intrapleural deoxyribonuclease (DNase) to enhance the drainage of pleural effusion. Here, we report two cases of thoracic empyema that were successfully treated with intrapleural saline irrigation and intrapleural tyloxapol apart from parenteral antibiotics as the pillar of the treatment. Both patients averted surgical procedure (decortication) and were discharged well. Upon follow-up, both cases showed clinical cure, biochemical recovery, and radiological improvement, indicating a good treatment outcome. This is the first reported cases on combination of saline irrigation with tyloxapol as alternative treatment for pleural infection.
多年来，脓胸的治疗方法一直在不断发展，包括使用胸膜内纤维蛋白溶解疗法（IPFT），例如，阿替普酶联合胸膜内脱氧核糖核酸酶（DNase）以增强胸腔积液的引流。在此，我们报告两例脓胸病例，除了将肠外抗生素作为治疗的支柱外，还通过胸膜内盐水冲洗和胸膜内聚氧乙烯蓖麻油成功治愈。两名患者均避免了外科手术（剥脱术），并顺利出院。随访时，两例均显示临床治愈、生化指标恢复及影像学改善，表明治疗效果良好。这是首次报道盐水冲洗联合聚氧乙烯蓖麻油作为胸膜感染替代治疗的病例。
