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:探讨中西医结合肺康复护理方案在结核性脓胸行胸腔镜清除术患者中的应用效果。方法:采用前瞻性研究方法,于2021年10月至2022年12月,连续纳入浙江大学医学院附属杭州市胸科医院新入院的符合手术指征的结核性脓胸患者66例,采用随机...目的:探讨中西医结合肺康复护理方案在结核性脓胸行胸腔镜清除术患者中的应用效果。方法:采用前瞻性研究方法,于2021年10月至2022年12月,连续纳入浙江大学医学院附属杭州市胸科医院新入院的符合手术指征的结核性脓胸患者66例,采用随机数字表法分为观察组(33例)和对照组(33例)。对照组采用常规护理,观察组在对照组基础上采用《结核性脓胸行胸腔镜清除术患者中西医结合肺康复护理方案》。比较两组研究对象入院当天、术后第2天、出院当天、出院后1个月的肺功能、日常生活能力、焦虑水平,以及术后第2天疼痛水平和术后胸管留置时间情况。结果:研究对象经治疗出院后1个月,对照组完成干预者28例,完成率为84.8%(28/33),观察组完成干预者31例,完成率为93.9%(31/33)。出院前、出院后1个月观察组第1秒用力呼气容积(forced expiratory volume in one second,FEV 1)水平[中位数(四分位数)]分别为1.83(1.60,2.29)L和2.20(2.00,2.32)L,均明显高于对照组[分别为1.58(1.43,1.83)L和1.91(1.88,2.04)L],差异均有统计学意义(Waldχ^(2)值分别为8.947和7.285,P值分别为0.003和0.007);观察组用力肺活量(forced vital capacity,FVC)水平分别为2.50(2.30,2.64)L和2.65(2.45,2.79)L,均明显高于对照组[分别为2.21(2.20,2.49)L和2.55(2.35,2.69)L],差异均有统计学意义(Waldχ^(2)值分别为10.072和5.708,P值分别为0.002和0.017)。术后第2天,观察组巴氏指数评分[中位数(四分位数)]为55.0(55.0,70.0)分,明显高于对照组[50.0(40.0,53.8)分],差异有统计学意义(Waldχ^(2)值=14.009,P<0.001)。出院前和出院后1个月观察组焦虑评分分别为(54.52±4.89)分和(49.58±3.91)分,均明显低于对照组[分别为(57.43±4.77)分和(54.61±3.98)分],差异均有统计学意义(t值分别为5.338和23.907,P值分别为0.025和<0.001)。观察组术后胸管留置时间为9(7,9)d,明显少于对照组[9(8,10)d],差异有统计学意义(Z=-2.076,P=0.038)。结论:中西医结合肺康复护理方案干预可改善结核性脓胸行胸腔镜清除术患者肺功能、降低焦虑水平、提升术后日常生活能力、缩短术后胸管留置时间,值得推广。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:探讨中西医结合肺康复护理方案在结核性脓胸行胸腔镜清除术患者中的应用效果。方法:采用前瞻性研究方法,于2021年10月至2022年12月,连续纳入浙江大学医学院附属杭州市胸科医院新入院的符合手术指征的结核性脓胸患者66例,采用随机数字表法分为观察组(33例)和对照组(33例)。对照组采用常规护理,观察组在对照组基础上采用《结核性脓胸行胸腔镜清除术患者中西医结合肺康复护理方案》。比较两组研究对象入院当天、术后第2天、出院当天、出院后1个月的肺功能、日常生活能力、焦虑水平,以及术后第2天疼痛水平和术后胸管留置时间情况。结果:研究对象经治疗出院后1个月,对照组完成干预者28例,完成率为84.8%(28/33),观察组完成干预者31例,完成率为93.9%(31/33)。出院前、出院后1个月观察组第1秒用力呼气容积(forced expiratory volume in one second,FEV 1)水平[中位数(四分位数)]分别为1.83(1.60,2.29)L和2.20(2.00,2.32)L,均明显高于对照组[分别为1.58(1.43,1.83)L和1.91(1.88,2.04)L],差异均有统计学意义(Waldχ^(2)值分别为8.947和7.285,P值分别为0.003和0.007);观察组用力肺活量(forced vital capacity,FVC)水平分别为2.50(2.30,2.64)L和2.65(2.45,2.79)L,均明显高于对照组[分别为2.21(2.20,2.49)L和2.55(2.35,2.69)L],差异均有统计学意义(Waldχ^(2)值分别为10.072和5.708,P值分别为0.002和0.017)。术后第2天,观察组巴氏指数评分[中位数(四分位数)]为55.0(55.0,70.0)分,明显高于对照组[50.0(40.0,53.8)分],差异有统计学意义(Waldχ^(2)值=14.009,P<0.001)。出院前和出院后1个月观察组焦虑评分分别为(54.52±4.89)分和(49.58±3.91)分,均明显低于对照组[分别为(57.43±4.77)分和(54.61±3.98)分],差异均有统计学意义(t值分别为5.338和23.907,P值分别为0.025和<0.001)。观察组术后胸管留置时间为9(7,9)d,明显少于对照组[9(8,10)d],差异有统计学意义(Z=-2.076,P=0.038)。结论:中西医结合肺康复护理方案干预可改善结核性脓胸行胸腔镜清除术患者肺功能、降低焦虑水平、提升术后日常生活能力、缩短术后胸管留置时间,值得推广。
