Mukhin E P, Izbagambetov N K, Mukushev N R
Grud Serdechnososudistaia Khir. 1993 May-Jun(3):37-40.
In contrast to non-specific pleural empyemas in which closed sanitization is sufficiently beneficial, an early application of thoracostoma is essential for patients with tuberculous pleural empyema with bronchial fistulas. Thoracostoma allows for effective sanitization of the cavity, long-term antituberculous chemotherapy and preparation of patients for radical operations. This has been supported by the comparative analysis of the outcomes of radical operations in 139 patients following closed and open management of the empyemic cavity in pulmonary tuberculosis. The site of thoracostoma is defined depending on the location and volume of an abscess and the forthcoming radical operation. Long-acting antiseptic dressings containing chlorohexidine bigluconate, which are based on the polymer polyhydroxyethyl methacrylate and which have been developed in the clinical setting, and ultraviolet irradiation with a unique-design apparatus are proposed for sanitization of open pleural empyemas.
与非特异性胸膜积脓（闭式消毒就足够有效）不同，对于伴有支气管瘘的结核性胸膜积脓患者，早期应用胸廓造口术至关重要。胸廓造口术可实现胸腔的有效消毒、长期抗结核化疗以及为患者进行根治性手术做准备。对139例肺结核患者在胸腔积脓腔进行闭式和开放处理后行根治性手术的结果进行的对比分析支持了这一点。胸廓造口术的位置取决于脓肿的位置和大小以及即将进行的根治性手术。提出使用基于聚甲基丙烯酸羟乙酯聚合物的含葡萄糖酸氯己定长效抗菌敷料（该敷料已在临床环境中研发）以及使用独特设计设备进行紫外线照射来对开放性胸膜积脓进行消毒。
