肺多房棘球蚴胸腔内感染致脓胸一例及文献复习

Empyema caused by intrathoracic infection of pulmonary multilocular echinococcus: a case report and a review of literature

目的探讨肺多房棘球蚴胸腔内感染导致脓胸的诊断与治疗。方法回顾性分析一例2016年8月至2016年9月于石河子大学医学院第一附属医院心胸外二科住院治疗的肺多房棘球蚴感染导致脓胸的病例,并查询相关文献,分析其临床诊疗特点(包括流行病学特点、临床表现、影像学表现),探讨手术治疗的具体术式与预后,结合本病例着重讨论了肺多房棘球蚴感染导致脓胸的诊断与治疗。结果由于缺乏特征性临床表现及影像学检查结果,该病例在治疗初期未明确诊断(只初步诊断为脓胸),经多方会诊后,最终决定行胸腔镜下脓胸清除术。最后在手术中确诊为肺多房棘球蚴感染导致脓胸,确诊后行胸腔镜下肺棘球蚴内囊摘除术+脓胸清除术,术后给予派西林他巴唑坦抗感染治疗。最终,患者顺利出院。结论肺多房棘球蚴感染致脓胸这种情况非常罕见,医务人员,尤其是非棘球蚴病流行地区的医务工作者应该提高警惕,提高对这类罕见情况的认识才能在早期明确诊断,进而采取有效治疗。结合外科手术和抗感染药物治疗肺多房棘球蚴感染致脓胸的疗效显著,可以有效治愈。

Objective To investigate the diagnosis and treatment of empyema caused by intrathoracic infection of pulmonary multilocular Echinococcus.Methods From August 2016 to September 2016,a case of empyema caused by pulmonary multilocular Echinococcus infection was analyzed retrospectively in the second Department of cardiothoracic surgery,the First Affiliated Hospital,School of Medicine,Shihezi University,and the relevant literature was consulted to analyze its clinical diagnosis and treatment characteristics(including epidemiological characteristics,clinical manifestations,imaging manifestations),and to explore the specific operation mode and prognosis of surgical treatment The diagnosis and treatment of empyema caused by pulmonary multilocular Echinococcus infection were discussed..Results Due to the lack of characteristic clinical manifestations and imaging examination results,the case was not clearly diagnosed at the early stage of treatment(only initially diagnosed as empyema).After multiple consultations,it was finally decided to perform thoracoscopic empyema removal.At last,it was confirmed that the infection of pulmonary multilocular hydatid caused empyema during the operation.After the diagnosis,it was treated by thoracoscopic intrathecal resection of pulmonary hydatid+empyema clearance.After the operation,it was treated with paixilin tazobactam.Finally,the patient was discharged smoothly.Conclusion Empyema caused by pulmonary multilocular echinococcosis is very rare.Medical workers,especially those in non echinococcosis endemic areas,should pay more attention to it.Only by improving the awareness of such rare cases can we make a clear diagnosis in the early stage and then take effective treatment.The combination of surgical operation treatment and anti infective drugs treatment can effectively cure empyema caused by pulmonary multilocular Echinococcus infection.