Strange C, Sahn S A
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston 29403-5851.
Chest. 1993 Jan;103(1):259-61. doi: 10.1378/chest.103.1.259.
Respondents at an interactive symposium on pleural space infections (n = 339) at the 1991 American College of Chest Physicians Annual Scientific Assembly recorded their personal management preferences for hypothetical patients with empyema. The group's preference was to treat pleural sepsis from an anaerobic multiloculated empyema by pleural decortication (49 percent); however, open thoracotomy with directed chest tube placement (22 percent), chest tube placement with intrapleural streptokinase (14 percent), placement of a single chest tube into the largest pleural loculus (8 percent), and placement of multiple small-bore catheters with computed tomographic guidance (7 percent) all had proponents. In the case of a multiloculated empyema not completely drained by a first chest tube in a nontoxic patient, the preference was drainage by a second chest tube, either a small-bore (42 percent) or a large-bore (36 percent) tube. The heterogeneity of responses suggests that prospective trials comparing treatment modalities are needed.
在1991年美国胸科医师学会年度科学大会上，一个关于胸膜腔感染的互动研讨会（n = 339）的受访者记录了他们对假设的脓胸患者的个人治疗偏好。该组的偏好是通过胸膜剥脱术治疗厌氧多房性脓胸引起的胸膜败血症（49%）；然而，开胸直视下放置胸管（22%）、胸管放置联合胸膜腔内链激酶（14%）、将单根胸管置入最大的胸膜腔（8%）以及在计算机断层扫描引导下放置多根细导管（7%）均有支持者。对于在无毒患者中首次胸管未完全引流的多房性脓胸，偏好是通过第二根胸管引流，细管（42%）或粗管（36%）。回答的异质性表明需要进行比较治疗方式的前瞻性试验。
