Early use of intrapleural fibrinolytics in the management of postpneumonic empyema. A prospective study

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• 作者：Panagiotis Misthos ; Evangelos Sepsas ; Marios Konstantinou ; Kalliopi Athanassiadi ; Ioannis Skottis and Achilles Lioulias
• 关键词：Thoracic empyema ; Chest tube thoracostomy ; Fibrinolysis
• 刊名：European Journal of Cardio-Thoracic Surgery
• 出版年：2005
• 出版时间：2005
• 年：2005
• 卷：28
• 期：4
• 页码：599-603
• 全文大小：83 K

文摘

Objective: A prospective randomized study was conducted in order to analyze the role of fibrinolytics in the treatment of complicated parapneumonic effusion. Methods: From 2001 to 2004, 127 consecutive patients were managed for thoracic empyema. In all cases the cause was bacterial pneumonia. Seventy patients were managed with sole tube thoracostomy (group A) and 57 with combination of tube thoracostomy and streptokinase instillation (group B). Groups were statistically compared for the age, gender, duration of symptoms, quality of pleural fluid, chest imaging, complete drainage, length of hospital stay and mortality. Multivariate analysis was used in order to define the factors that affect outcome. Results: Tube thoracostomy was successful in 47 (67.1 % ) cases (group A), while fibrinolysis led to a favorable outcome in 50 cases (87.7 % ) (P<0.05). The length of stay in thoracic surgical department was significantly longer for group A (P<0.001). Mortality rate in group A was significantly higher (P<0.001). Multiple regression analysis disclosed as sole independent favorable factor for pleural drainage, the use of fibrinolysis during the course of chest tube drainage (P