26例慢性重症脓胸的诊治分析

目的总结慢性重症脓胸的临床特点及诊疗体会。方法回顾性分析2006年5月-2011年4月共26例慢性重症脓胸的临床表现和治疗过程,其中12例采用胸膜纤维板剥脱术,8例采用胸廓成形术,6例采用胸膜肺切除。结果所有病例均临床治愈,术后康复时间14～68d,平均28.7d,脓腔全部清除,空洞消除,瘘口闭合,肺功能改善明显,手术前后差异有统计学意义(P<0.05);术前肺功能测定最大肺活量为(38.8±4.87)%,第1秒用力呼气容积为(1.48±0.21)L,最大通气量为(37.6±5.29)%,出院前上述3项值分别为(77.2±7.41)%、(2.62±0.47)L、(71.9±6.88)%。结论对慢性重症脓胸要积极手术治疗。

Diagnosis and treatment of 26 patients with chronic serious empyema

OBJECTIVE To evaluated the diagnosis and treatment of chronic serious empyema.METHODS The clinical data of 26 cases of chronic serious empyema from May 2006 to Apr 2011 were analyzed retrospectively,among which 12 cases were treated with decortication,8 cases were treated with thoracoplasty,6 cases were treated with pleuropneumonectomy.RESULTS All cases were clinically cured,the postoperative recovery time was 14-68 d with the average time of 28.7 d,all abscess were removed,hole was eliminated,fistula was closed,pulmonary function was improved significantly,the differences before and after the operation were statistically significant(P<0.05);the percentage of forced vital capability before the treatment was(38.8±4.87)%,the forced expiratory volume of the first second was(1.48±0.21)L,the maximum voluntary ventilation was(37.6±5.29)%,the three values mentioned above were respectively(77.2±7.41)%,(2.62±0.47)L,and(71.9±6.88)% before the discharge from hospital.CONCLUSION Surgical treatment should be performed actively to the chronic serious empyema.