Sriussadaporn S, Poomsuwan P
Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 1995 Aug;78(8):393-8.
Three out of 42 patients who had isolated blunt chest injury requiring closed tube thoracostomy developed post-traumatic empyema thoracis. All of them were treated by thoracotomy and evacuation of the infected fluid with multiple chest tube drainage. Cultures of the pleural fluid grew Staphylococcus aureus in these 3 patients. Univariate analysis was performed by using Fisher's exact test which revealed the significance of age in association with the development of empyema thoracis. Multivariate analysis was performed by using Logistic Regression. Although no statistical significance was observed, the analysis revealed that the risk of empyema thoracis increased in elderly patients and in patients who had prolonged placement of thoracostomy tube. Intensive pulmonary care in elderly patients who sustained chest injury and early removal of thoracostomy tube is recommended in order to prevent the development of empyema thoracis.
42例单纯性钝性胸部损伤需要进行闭式胸腔引流术的患者中，有3例发生了创伤后脓胸。所有患者均接受了开胸手术，并通过多根胸腔引流管排出感染液。这3例患者的胸腔积液培养均生长出金黄色葡萄球菌。采用Fisher精确检验进行单因素分析，结果显示年龄与脓胸的发生具有相关性。采用Logistic回归进行多因素分析。虽然未观察到统计学意义，但分析显示老年患者和胸腔造口管放置时间延长的患者发生脓胸的风险增加。建议对胸部受伤的老年患者进行强化肺部护理，并尽早拔除胸腔造口管，以预防脓胸的发生。
