Mushegera C K, Mbuyi-Muamba J M, Kabemba M J
Department of Surgery, University Hospital, Kinshasa, Zaïre.
Acta Chir Belg. 1996 Sep-Oct;96(5):217-22.
In a retrospective and prospective study the authors assess factors influencing postoperative results in patients operated on for pachypleuritis with late referral to the hospital. There were 78 cases in the retrospective (1970-1984) and 28 cases in the prospective (1985-1992) parts of the study. The total number of treated cases is 106 (75 males and 31 females). There were 32 children (> 15 years of age) and 74 adults (< or = 15 years). General condition was good in 45 patients (11 children and 34 adults) and poor in 61 patients (21 children and 40 adults). Ninety percent of the patients were operated on at least one month after the appearance of their symptoms. Eighty-one patients (75.4%) had an empyema secondary to bronchopulmonary infection (34 tuberculous). Other etiologies were: thoracic trauma: 23 cases (19 open and 4 internal); miscellaneous: 2 cases. The commonest isolated organisms were S. aureus, (21.4%), Klebsiella (21.4%) Pseudomonas (13%), Proteus mirabilis, P. vulgaris, P. aeruginosa (11.9%), E. coli (8.4%) and Pyocyaneus (5.9%). In all cases, a total decortication was performed. Good result was achieved in 55/106 (51.8%). There were 39/106 (36.9%) poor results and 12 operative deaths (11.3%). No correlation could be found between results and age, sex or etiology. A significant correlation appeared between duration of symptoms and postoperative results. The longer the delay; the worse the results.
在一项回顾性和前瞻性研究中，作者评估了影响因肥厚性胸膜炎而延迟入院治疗的患者术后结果的因素。该研究回顾性部分（1970 - 1984年）有78例，前瞻性部分（1985 - 1992年）有28例。治疗的病例总数为106例（男性75例，女性31例）。其中有32名儿童（>15岁）和74名成人（≤15岁）。45例患者（11名儿童和34名成人）的一般状况良好，61例患者（21名儿童和40名成人）的一般状况较差。90%的患者在症状出现至少一个月后接受了手术。81例患者（75.4%）继发于支气管肺部感染形成脓胸（34例为结核性）。其他病因包括：胸部创伤23例（19例开放性创伤和4例闭合性创伤）；其他杂项病因2例。最常见的分离菌为金黄色葡萄球菌（21.4%）、克雷伯菌（21.4%）、铜绿假单胞菌（13%）、奇异变形杆菌、普通变形杆菌、铜绿假单胞菌（11.9%）、大肠杆菌（8.4%）和绿脓杆菌（5.9%）。所有病例均进行了全胸膜剥脱术。106例中有55例（51.8%）取得了良好效果。106例中有39例（36.9%）效果较差，12例手术死亡（11.3%）。结果与年龄、性别或病因之间未发现相关性。症状持续时间与术后结果之间存在显著相关性。延迟时间越长，结果越差。
