Yagi K, Hirata T, Kawashima M, Takashima T, Reshad K
Department of Thoracic Surgery, Kyoto University, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1995 Sep;43(9):1549-52.
Thoracoscopic debridement for acute empyema was successfully performed in three patients who were refractory to closed drainage, irrigation and antibiotic therapy. In two patients anaerobic organisms were isolated from the pus. None of the patients had bronchopleural fistula. All patients were relieved of fever promptly after surgery. Operative invasion was minimal, and postoperative lung function was well maintained one month after the operation. If empyema is in the fibrinopurulent phase and does not respond to pleural drainage, thoracoscopic debridement may be indicated before more aggressive therapy.
对3例闭式引流、冲洗及抗生素治疗无效的急性脓胸患者成功实施了胸腔镜清创术。2例患者的脓液中分离出厌氧菌。所有患者均未发生支气管胸膜瘘。所有患者术后发热症状迅速缓解。手术创伤极小,术后1个月肺功能维持良好。如果脓胸处于纤维脓性期且对胸腔引流无反应,在采取更积极的治疗之前可考虑胸腔镜清创术。