Decade Experience in Pleurectomy and Lung Decortications for Chronic Empyema Thoracis

Background: Chronic empyema thoracis is a debilitating illness with high morbidity and mortality, and is seen among all age groups in Nigeria. Objective: To review all cases of chronic empyema thoracis treated by pleurectomy and lung decortication and highlight the indications, challenges and the outcome. Materials and Method: In a 10-year period spanning 2007-2016, 90 patients with chronic empyema thoracis were admitted and managed in our institution. A retrospective study of 36 patients who underwent surgery was performed. Results: Ten patients (27.80%) out of 36 patients had unsuccessful one month closed chest tube drainage (CTTD). Six patients (16.67%) were referred from peripheral hospitals as chronic empyema thoracis that had failed CTTD. The remainder, 20 (55.60%) were diagnosed as chronic empyema thoracis de novo. Conclusion: Chronic empyema thoracis is a very difficult disease to manage especially in developing countries like ours, where patients present very late and the requisite facilities are inadequate.

梗阻性肾积水声像图表现及其意义

目的探讨梗阻性肾积水的不同声像图表现及其意义。方法对2004年7月至2007年12月间,经超声检查和手术证实梗阻性肾积水36例声像图表现与临床手术所见进行对照分析。结果本组病例声像图主要有3种表现:(1)扩张的肾盂内出现沉积物分层现象,其上部为液性无回声区,内有点状、絮状回声飘动;下部为沉积物形成的中高回声区,形成液平面。沉积物可随体位改变而改变;(2)扩张的肾盂内有散在的点状、絮状回声飘动。以上两种类型占25%(9/36);(3)扩张的肾盂内无回声,占75%(27/36)。扩张的肾盂区内有沉积物分层或点状絮状回声时,手术证实肾积水为脓性,前者为脓液黏稠,呈较大颗粒状沉积,后者为脓液相对稀薄或比较均匀;扩张的肾盂内无回声患者,手术证实23例(23/27)为单纯性肾积水,4例(4/27)为肾积水合并感染。结论超声检查多数情况下可以区分肾积水与肾盂积脓,对两者的鉴别诊断比CT更加敏感。