- 期刊
以經皮胸腔導管引流治療肺膿瘍
Percutaneous Transthoracic Catheter Drainage for Lung Abscess
摘要
肺膿瘍(Lung abscess)為一種肺實質化膿性的細菌感染，引起組織壞死，引發肺實質開洞形成空氣液面(air-fluid level)變化。病程表現有可能為急性，慢性或亞急性，以發燒，咳嗽，咳血，胸痛或呼吸困難來表現，一般肺膿瘍由內科治療為主，大部分可痊癒，11-21%則需要外科肺葉切除手術或經皮胸腔導管引流。診斷靠胸部X光檢查，實驗室數值和臨床症狀。胸部電腦斷層檢查除了可明確鑑別診斷排除膿胸(empyema)，壞死性肺炎等疾病外，亦可以電腦斷層作導引操作經皮胸腔導管引流，合併症為大出血，氣胸或支氣管肋膜瘻管(bronchopleural fistula)等。本文報告一位76歲女性，因呼吸困難住院，胸部X光呈現右下肺葉浸潤和開洞病變。入院使用抗生素並作經皮胸腔超音波抽取，再以胸腔豬尾巴導管(pigtail cathelter)藉著金屬導線(guide wire)插入，接胸管引流瓶抽吸，預後良好。並回溯相關文獻。
並列摘要
Lung abscess is defined as suppuration with destruction of lung parenchyma leading to cavity formation with radiographic findings of an air-fluid level in the cavity. Most lung abscesses can be successfully treated with antibiotics. About 11% to 21% of cases need surgical intervention or percutaneous drainage. We herein report a case of a 76-year-old woman with lung abscess who received antibiotic therapy and percutaneous transthoracic catheter drainage. The clinical features, diagnostic procedure, therapeutic assessment and prognosis are discussed.