Lung abscess pneumonectomy

Lung abscess is a purulent lesion of the lung tissue caused by various pathogens. The early stage is suppurative pneumonia, followed by necrosis and liquefaction, forming an abscess. The principle of treatment for lung abscess is to select sensitive drugs for anti-inflammatory and to take appropriate methods for abscess drainage. Actively giving effective antibacterial drugs in the early stage, the body temperature dropped to normal in 3 to 10 days. The total course of antibiotics is 6 to 8 weeks until the clinical symptoms completely disappear. Patients with more sputum drainage and drainage and use of phlegm drugs, aerosol inhalation. If the treatment is effective, the X-ray shows that the abscess and inflammatory lesions are completely dissipated, and only the cords are left. Surgical treatment is given to patients with poor long-term medical treatment. Surgical treatment includes abscess drainage and pneumonectomy. Treatment of diseases: lung abscess Indication 1. For more than 3 months of chronic lung abscess, non-surgical treatment did not improve, repeated authors. 2. Lung abscess larger than 6cm in diameter, the drug is not easy to cure. 3. No response to medical treatment, weekly chest X-ray or chest-transparent comparison, abscess not only does not shrink but continues to increase, the liquid in the abscess increases, the surrounding inflammation does not subside or combined with sepsis. 4. Patients with hemoptysis may undergo surgery after symptom relief. However, if the hemoptysis reaches 500ml or more within 12h, surgery should be performed early. 5. Lung abscess breaks into the pleural cavity, causing bronchopleural fistula, empyema, simple chest drainage is difficult to control the development of the disease. 6. Can not be distinguished from lung cancer. Preoperative preparation Improve the general condition of patients, strengthen nutrition, correct anemia and hypoproteinemia. The position is drained and drained, and the amount of daily sputum is reduced to less than 50 ml. Apply sensitive broad-spectrum antibiotics. complication Blood chest Before the chest is closed, the chest wall, diaphragm and intercostal space should be carefully examined. Especially for the wound with adhesion, it should be carefully coagulated and burned. Check for loosening of the vascular ligation line. After careful observation and record the color and quantity of the thoracic drainage fluid, under normal circumstances, it should be gradually reduced, the color becomes lighter. If it continues to ooze or decrease, it will suddenly increase. The blood of the drainage fluid will become thicker and should be alert to active bleeding in the chest. Can first give hemostatic drugs, static fibrinogen, after conservative treatment for 4 ~ 6h, if the chest drainage is still a thicker bloody exudate, more than 100ml per hour, and blood pressure drops, pulse increases, chest radiograph When there is a moderate amount of fluid or large clots in the chest, you should consider reopening the chest to stop bleeding and remove the blood clots in the chest. 2. Bronchial pleural fistula Because of the inflammatory changes and infection of the bronchi of the lung abscess, the bronchial mucosa has poor healing ability. If the bronchial stump is not properly treated, it may cause bronchopleural palsy in the postoperative period. 3. Thoracic infection or empyema Intraoperative abscess rupture contaminated the thoracic cavity, the thoracic cavity was not completely flushed, the lesion was not completely removed, the lung wound was leaked, the chest drainage tube was removed prematurely, or the pleural effusion was not treated in time. These factors can cause postoperative operation. Thoracic infection or empyema.

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