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目的:研究小儿脓胸经保守治疗后多长时间选择手术治疗为佳。方法:72例患儿分为两组。Ⅰ组手术时间在60天以上,Ⅱ组手术时间在35天以内。结果:除13例保守治愈外,两组均应用抗生素,行胸膜腔穿刺和胸腔闭式引流失败后再行扩清术。通过术中出血量、纤维板厚度、手术时间、术后应用抗生素时间和术后出院时间对比,两组有极显著性差异(P<0.001)。结论:小儿脓胸以金黄色葡萄球菌感染者占首位。此种细菌早期即形成粘稠脓汁、多房性脓腔和纤维包膜,是保守治疗失败的主要原因,应早期行扩清术。此术式是简单、安全和有效的方法。
Objective: To study how long it is better to choose surgical treatment after conservative treatment of pediatric empyema. Methods: 72 children were divided into two groups. The operation time of group Ⅰ was more than 60 days, the operation time of group Ⅱ was less than 35 days. RESULTS: Except for 13 cases of conservative cure, antibiotics were administered in both groups, followed by pleural puncture and failed thoracic drainage. There was a significant difference between the two groups (P <0.001) by comparing intraoperative blood loss, fibrin thickness, operation time, postoperative antibiotic time and postoperative discharge time. Conclusion: The infection of S. aureus in pediatric empyema patients is the highest. The early formation of such bacteria, thick pus juice, multi-abscess and fibrous capsule capsule is the main reason for the failure of conservative treatment should be performed early expansion surgery. This procedure is a simple, safe and effective method.