Gelfand E T, Mehta H, Callaghan J C
Can J Surg. 1981 Sep;24(5):458-60.
There is limited experience world wide in the management of patients with cystic fibrosis who undergo thoracotomy. Because of their shortened life-span and the diffuse nature of pulmonary involvement, resection is seldom performed for uncontrolled pulmonary infections. An 8-year-old boy with cystic fibrosis and a chronic infection of the right lung with abscess formation underwent pulmonary resection after 1 week of antibiotic therapy with tobramycin, ticarcillin and cloxacillin, and physiotherapy. Postoperatively, he was kept in the intensive care unit for 48 hours. Physiotherapy was begun immediately after operation and continued every 2 hours for the first day. The preoperative antibiotic therapy was continued. The postoperative course was smooth and the boy did well for 1 year. Over the next 6 months his condition deteriorated and he died 18 months after operation. Pulmonary resection should not be used in patients whose pulmonary infections can be controlled medically but may be of value for those with uncontrollable localized infections.
全世界范围内,接受开胸手术的囊性纤维化患者的管理经验有限。由于他们的寿命缩短以及肺部受累的弥漫性,很少因无法控制的肺部感染而进行切除术。一名8岁患有囊性纤维化且右肺慢性感染并形成脓肿的男孩,在接受妥布霉素、替卡西林和氯唑西林抗生素治疗1周及物理治疗后,进行了肺切除术。术后,他在重症监护病房待了48小时。术后立即开始物理治疗,术后第一天每2小时进行一次,并继续术前的抗生素治疗。术后过程顺利,该男孩术后1年情况良好。在接下来的6个月里,他的病情恶化,术后18个月死亡。对于肺部感染可通过药物控制的患者,不应采用肺切除术,但对于那些有无法控制的局限性感染的患者可能有价值。