Objectives: Chronic empyema thoracis (CET) is common worldwide despite widespread use of highly effective antibiotics. Also, newer technological armamentaria are available for its diagnosis and treatment. This researc...Objectives: Chronic empyema thoracis (CET) is common worldwide despite widespread use of highly effective antibiotics. Also, newer technological armamentaria are available for its diagnosis and treatment. This research was performed to study the aetiopathological profile and the management challenges of CET in view of the background information stated above. Methods: It is a prospective study spanning a period of 62 months in Lagos, Nigeria. Patients’ bio-data, aetiological factors, salient clinical features, management modalities and complications of care were documented and analysed. We excluded patients who were not fit for surgery and those who could not afford surgery. Patients that were initially registered as chronic empyema patients but who later became positive for malignancy were also excluded. Results: There were 93 patients (61 males and 31 females). Age range was 4-72 years but the range 20-49 years constituted 71.0% of the studied population. Poorly treated acute chest infections was the aetiological factor in 49.5% of patients. Tuberculosis was established in 37 patients (39.8%) who were especially in social classes I and II. Decortication and pneumonectomy were done for 52.7% and 16.1% of the patients respectively. Average hospitalisation was prolonged for pneumonectomy because some patients had pneumonectomy space infections. Discusion: CET remains a worldwide problem despite widespread use of potent antibiotics. There are newer diagnostic and therapeutic armamentaria that are not readily available in developing world thereby posing major challenges to practicing surgeons.展开更多
目的探讨对慢性脓胸患者行电视胸腔镜手术治疗的临床效果及影响因素。方法选取2012年5月至2015年5月接收的慢性脓胸患者74例为研究对象，按照抽签法将其划分为实验组、对照组，分别行电视胸腔镜手术治疗、常规开胸术治疗，对比两组疗效...目的探讨对慢性脓胸患者行电视胸腔镜手术治疗的临床效果及影响因素。方法选取2012年5月至2015年5月接收的慢性脓胸患者74例为研究对象，按照抽签法将其划分为实验组、对照组，分别行电视胸腔镜手术治疗、常规开胸术治疗，对比两组疗效，并对疗效影响因素行Logistic回归性分析。结果实验组手术时间（min：78．25±19．85VS159．62±33．63）及术后住院时间（d：14．21±1．96 vs 16．35±2．82）、留置引流管时间（d：2．15±0．32 vs 4．52±0．63）均短于对照组，术中出血量（ml：106．32±25．41 vs 451．32±112．82）及术后引流量（ml：521．36±52．14 vs 864．36±158．65）低于对照组，差异有统计学意义（P〈0．05）；经Logistic回归性分析发现，电视胸腔镜手术治疗效果与病程、年龄、医师手术操作熟练程度及胸膜粘连具有相关性（P〈0．05）。结论慢性脓胸患者行电视胸腔镜手术治疗具有可行性，而临床医生手术操作熟练程度、胸膜粘连与疗效密切相关，须引起足够重视。展开更多
文摘Objectives: Chronic empyema thoracis (CET) is common worldwide despite widespread use of highly effective antibiotics. Also, newer technological armamentaria are available for its diagnosis and treatment. This research was performed to study the aetiopathological profile and the management challenges of CET in view of the background information stated above. Methods: It is a prospective study spanning a period of 62 months in Lagos, Nigeria. Patients’ bio-data, aetiological factors, salient clinical features, management modalities and complications of care were documented and analysed. We excluded patients who were not fit for surgery and those who could not afford surgery. Patients that were initially registered as chronic empyema patients but who later became positive for malignancy were also excluded. Results: There were 93 patients (61 males and 31 females). Age range was 4-72 years but the range 20-49 years constituted 71.0% of the studied population. Poorly treated acute chest infections was the aetiological factor in 49.5% of patients. Tuberculosis was established in 37 patients (39.8%) who were especially in social classes I and II. Decortication and pneumonectomy were done for 52.7% and 16.1% of the patients respectively. Average hospitalisation was prolonged for pneumonectomy because some patients had pneumonectomy space infections. Discusion: CET remains a worldwide problem despite widespread use of potent antibiotics. There are newer diagnostic and therapeutic armamentaria that are not readily available in developing world thereby posing major challenges to practicing surgeons.
文摘目的探讨对慢性脓胸患者行电视胸腔镜手术治疗的临床效果及影响因素。方法选取2012年5月至2015年5月接收的慢性脓胸患者74例为研究对象，按照抽签法将其划分为实验组、对照组，分别行电视胸腔镜手术治疗、常规开胸术治疗，对比两组疗效，并对疗效影响因素行Logistic回归性分析。结果实验组手术时间（min：78．25±19．85VS159．62±33．63）及术后住院时间（d：14．21±1．96 vs 16．35±2．82）、留置引流管时间（d：2．15±0．32 vs 4．52±0．63）均短于对照组，术中出血量（ml：106．32±25．41 vs 451．32±112．82）及术后引流量（ml：521．36±52．14 vs 864．36±158．65）低于对照组，差异有统计学意义（P〈0．05）；经Logistic回归性分析发现，电视胸腔镜手术治疗效果与病程、年龄、医师手术操作熟练程度及胸膜粘连具有相关性（P〈0．05）。结论慢性脓胸患者行电视胸腔镜手术治疗具有可行性，而临床医生手术操作熟练程度、胸膜粘连与疗效密切相关，须引起足够重视。
