小儿脓胸的外科诊断与治疗  

Surgical Diagnosis and Treatment of Empyema in Children

作　　者：陈忠建[1] 翟波[1] 王鹏高[1] 和东阳[1] 董向阳[1] 杨房[1] 李基伟[1] 

机构地区：[1]郑州市儿童医院心胸外科,450053

出　　处：《医学研究杂志》2009年第12期88-89,共2页Journal of Medical Research

摘　　要：目的探讨小儿脓胸的外科诊断,治疗和手术时机选择的问题。方法 2003年7月～2009年3月共收治55例小儿脓胸患者,其中男性30例,女性25例,平均体重11.4kg,年龄由3个月～1l岁,2例积液量少行胸腔穿刺抽液,其余均在局麻下胸腔闭式引流,其中21例痊愈,32例采取胸膜纤维板剥脱术,1例行胸膜纤维板剥脱术及局部胸廓成形术。结果胸腔闭式引流中21例痊愈,32例采取早期胸膜剥脱术,3例术后合并支气管胸膜漏,其中2例持续胸腔闭式引流两周自行恢复,1例再次手术29例其余恢复良好,全组无手术死亡,随访3～24个月均无复发、无胸廓畸形等并发症。结论小儿脓胸及时明确诊断积极保守治疗,一旦吸收较慢,有迁延趋势,掌握手术时机,尽早行胸膜纤维板剥脱术,手术正确处理,可取得满意的治疗效果。Objective To explore the surgical diagnosis of pediatric empyema, treatment and surgical operation opportunity. Methods From July 2003 to March 2009, 55 cases were treated , and pleural effusion was punctured in 2 cases. Closed drainage of thoracic cavitythe was done under local anesthesia in rest cases. 21 case fully recovered and 32 cases were taken pleural decortication. One case was taken pleural decortication and thoracoplasty. Results There was no operative mortality. After follow - up of 3 to 24 months, there was no recurrence , no complications such as thoracic deformity. Conclusion Pediatric empyema need timely diagnosis and active conservative treatment. Once fluidify absorbed slowly and there was persistent tendency, operation need to be done as soon as possible. After pleural decortication, we can get satisfied therapeutic effect.

关 键 词：小儿 脓胸 外科 诊断 

分 类 号：R726.55[医药卫生—儿科] R604[医药卫生—临床医学]