多根多处分段肋骨切除胸廓成形术

1978年至1988年间,应用多根多处分段肋骨切除胸廓成形术治疗慢性脓胸20例,经2～10年随访观察,效果良好。这种改良式胸廓成形术分段切除肋骨,保留大部分肋骨,它具有以下优点:手术创伤小,操作简便,易于掌握;常规加压包扎即可避免发生反常呼吸;术后胸廓畸形较轻;肺功能较术前无明显降低等。     

PLEURAL EMPYEMA IN A NEWBORN INFANT An Unusual Cause of Respiratory Distress

Abstract. In a 2-day-old baby with symptoms of respiratory distress a right-sided pleural empyema caused by haemolytic streptococci was found. Possible sources of infection are discussed. The mother had purulent discharge from a tooth a few weeks before delivery, and this may have been the focus. The baby was treated with pleural drainage and ampicillin with good result.     

Neuroradiology case presentation

A 16-year-old boy presented with a 9-day history of intermittent severe generalized headaches and confusional state. On the day of hospitalization, the patient had several focal seizures involving the right side of the body; he subsequently became increasingly lethargic and developed an expressive aphasia. Examination revealed a lethargic, febrile patient with a mild right hemiparesis and expressive aphasia.     

Video-assisted thoracoscopic surgery in the management of loculated empyema

Background: Fibropurulent empyema (stage II of Light) does not respond to antibiotic therapy and simple drainage. If the condition is inadequately treated, restrictive pulmonary deficit develops, necessitating thoracotomy and decortication. We report our experience with the videoscopic management of stage II and limited stage III disease. Methods: Ten consecutive patients underwent videoscopic debridement of fibropurulent empyema; three of them required removal of limited visceral and parietal rind. Results: The mean operating time was 42 ± 8.1 min. Postoperative pyrexia and leucocytosis settled within 4.2 ± 2.1 days and 13.1 ± 3.2 days, respectively. Intercostal chest tubes were removed by 4.5 ± 1.0 days. The mean fall in hematocrit following surgery was 4.9%. Parenteral analgesics were required for 1.0 ± 0.5 days and oral analgesics for 3 ± 1.6 days. The mean postoperative stay was 11 ± 8.1 days. No patient required any further intervention. Conclusions: Videoscopic debridement of empyema produces excellent results, with minimal patient morbidity and a short hospital stay. We recommend it as the preferred method for first-line management of fibropurulent (stage II) empyema. Received: 10 December 1998/Accepted: 13 May 1999     

20例慢性脓胸患者术后胸腔冲洗的护理

探讨慢性脓胸患者术后胸腔冲洗的护理.回顾2009年1月至2011年6月在我院就诊的行脓胸清除术后予以胸腔冲洗治疗及护理的20例慢性脓胸患者临床资料.冲洗2个疗程后,19例患者基本治愈;治疗结束后,所有患者均治愈,脓腔消失;随访1～3年,均未见复发.做好慢性脓胸患者术后胸腔冲洗的护理是减少术后并发症,缩短住院时间,提高治愈率的保证.