原发性肺癌并发脓胸3例报道并文献复习

Primary pulmonary carcinoma accompanying empyema: A report of 3 cases and literature review

目的提高临床医生对原发性肺癌并发脓胸的认识。方法报道我院3例原发性肺癌并发脓胸病例资料并复习相关文献,对其病因、临床特点、诊断及治疗进行总结。结果本文报道3例,检索中国知网和Pubmed文献库(1980-2012)的国内外文献报道9例。共12例肺癌并发脓胸的患者中,男女比例为5∶1,病理类型以鳞癌为主(10/12),且肿瘤TNM分期均为T2N1M0/ⅡB期以后中央型肺癌患者。4例为全身化疗后出现脓胸,其余8例为治疗前出现。引起脓胸的病原菌以链球菌为主。12例均接受了胸腔闭式引流术及全身抗生素治疗,其中6例接受了手术治疗,5例患者生存期不足2年。结论肺癌并发脓胸患者治疗困难,预后较差,控制感染后的手术治疗可能有助于改善患者预后。

Objective To improve the understanding of primary pulmonary carcinoma accompanying empyema in clinicians.Methods Three cases of primary pulmonary carcinoma accompanying empyema were reported with its related literature reviewed and its etiology,clinical features,diagnosis and treatment summarized.Results The male and female ratio was 5 ： 1.Of the 12 patients,10 were diagnosed with squamous cell carcinoma which was classified as central lung cancer at the T2N1M0/IIB phase according to the TNM.Empyema occurred in 4 cases after chemotherapy and in 8 cases before chemotherapy.The pathogenic microorganism of empyema was Streptococcus.Of the 12 patients who underwent closed thoracic drainage and systemic antimicrobial treatment,6 received surgery and 5 survived less than 2 years.Conclusion It is difficult to treat primary pulmonary carcinoma accompanying empyema and its prognosis is poor.Surgery contributes to its prognosis when infection is controlled.