Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eight...Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.展开更多
Introduction: The pyothorax or thoracic empyema is defined by the presence between the two pleural layers of a purulent liquid, or a non-purulent liquid, but with bacteriological or biochemical characteristics testify...Introduction: The pyothorax or thoracic empyema is defined by the presence between the two pleural layers of a purulent liquid, or a non-purulent liquid, but with bacteriological or biochemical characteristics testifying to a microbial invasion. The use of early medical treatment prevents the passage to pleural encystment, whose management remains surgical. Material and Methods: Our study was performed retrospectively, in the department of thoracic surgery of CHU Hassan II of Fez, between 2010 and 2016, involving 172 patients operated for pyothorax. Results: Among the 172 patients included in our study, there were 110 men and 67 women. The average age was 32.11 years old. The clinical picture was dominated by pleural syndrome in 56% of cases, signs of tuberculous impregnation in 44.1% of cases. Preoperative preparation with thoracic drainage, bi-antibiotic therapy and respiratory physiotherapy was performed in 90% of cases. The attack was right in 55.8% of cases and left in 44.1%. A chest CT scan performed in all patients showed pachypleuritis in all cases. The tuberculous pyothorax accounted for 54% of cases, those by intra pleural rupture of a pulmonary hydatid cyst in 10.4%, para-pneumonic origin in 5.2% and post-traumatic in 4.06%. The origin was undetermined in 26.16%. A conservative posterolateral thoracotomy was performed in all our patients. The pulmonary release was done through the extrapleural plane in 94% of cases, and pleuropulmonary decortication performed in all cases. Atypical resection was associated in 4.3% of cases and peri-cytectomy in 13.9% of cases. Operative follow-up was simple in 79.6% of cases. The main postoperative complications were a prolonged aerial leak in 16.7%, atelectasis in 4.5%, a wall infection in 6.5%, a hemothorax refrained in 3.2% of cases. The average follow-up was 2.5 years. Conclusion:?Tuberculosis remains the most common etiology of pyothorax in our setting. Early management plays an important role in reducing the morbidity and mortality of this pathology. However, surgery remains the only effective treatment at the pleural encystment stage.展开更多
<span style="font-family:Verdana;">Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liq...<span style="font-family:Verdana;">Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liquid but containing a majority of altered polynuclear cells with germs direct examination. They are said to be traumatic when they follow a </span><span style="font-family:Verdana;">thoracic trauma whatever the mechanism;usually a pre-existing post-traumatic</span><span style="font-family:Verdana;"> pleural effusion. The general objective of this study was to help identify the epidemiological and prognostic factors in the management of post-traumatic pyothorax in the Thoracic Surgery Department of the Donka National Hospital.</span><b><span style="font-family:Verdana;"> Methodology: </span></b><span style="font-family:Verdana;">This was a descriptive retrospective study covering a period of 2.5 years from 01/06/2016 to 31/12/2018 carried out in the Thoracic Surgery Department of the Donka National Hospital.</span><b><span style="font-family:Verdana;"> Results</span></b><b><span style="font-family:Verdana;" "="">:</span><span "=""> </span></b><span "=""><span style="font-family:Verdana;">During the study period, 17 cases of post-traumatic pyothorax were observed among the 288 files of admitted and hospitalized patients. In the course of this study, a rate was 5.90%. The most affected age group was 1 to 5 years old. The male sex was in the majority (76.5%). The most common occurrence was the fall, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> 41.2%. 47% of patients consult after 60 days. Chest pain and dyspnea were the main symptoms during our study (82.3%). Antibiotics and analgesics dominated the medical treatment used in 100% of the cases and pleural drainage was the first line surgical treatment practiced in 88.2% of the cases. The prognosis is favorable without sequelae in 52.9% of cases with an average hospital stay of 9 days. Post-traumatic pyothorax is a serious pathology involving the vital and functional respiratory prognosis, hence the need to diagnose and treat it early.</span></span>展开更多
基金Research Project of the Xi’an Municipal Health Commission(No.2023yb40,Project leader:Duan Chunyu)。
文摘Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.
文摘Introduction: The pyothorax or thoracic empyema is defined by the presence between the two pleural layers of a purulent liquid, or a non-purulent liquid, but with bacteriological or biochemical characteristics testifying to a microbial invasion. The use of early medical treatment prevents the passage to pleural encystment, whose management remains surgical. Material and Methods: Our study was performed retrospectively, in the department of thoracic surgery of CHU Hassan II of Fez, between 2010 and 2016, involving 172 patients operated for pyothorax. Results: Among the 172 patients included in our study, there were 110 men and 67 women. The average age was 32.11 years old. The clinical picture was dominated by pleural syndrome in 56% of cases, signs of tuberculous impregnation in 44.1% of cases. Preoperative preparation with thoracic drainage, bi-antibiotic therapy and respiratory physiotherapy was performed in 90% of cases. The attack was right in 55.8% of cases and left in 44.1%. A chest CT scan performed in all patients showed pachypleuritis in all cases. The tuberculous pyothorax accounted for 54% of cases, those by intra pleural rupture of a pulmonary hydatid cyst in 10.4%, para-pneumonic origin in 5.2% and post-traumatic in 4.06%. The origin was undetermined in 26.16%. A conservative posterolateral thoracotomy was performed in all our patients. The pulmonary release was done through the extrapleural plane in 94% of cases, and pleuropulmonary decortication performed in all cases. Atypical resection was associated in 4.3% of cases and peri-cytectomy in 13.9% of cases. Operative follow-up was simple in 79.6% of cases. The main postoperative complications were a prolonged aerial leak in 16.7%, atelectasis in 4.5%, a wall infection in 6.5%, a hemothorax refrained in 3.2% of cases. The average follow-up was 2.5 years. Conclusion:?Tuberculosis remains the most common etiology of pyothorax in our setting. Early management plays an important role in reducing the morbidity and mortality of this pathology. However, surgery remains the only effective treatment at the pleural encystment stage.
文摘<span style="font-family:Verdana;">Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liquid but containing a majority of altered polynuclear cells with germs direct examination. They are said to be traumatic when they follow a </span><span style="font-family:Verdana;">thoracic trauma whatever the mechanism;usually a pre-existing post-traumatic</span><span style="font-family:Verdana;"> pleural effusion. The general objective of this study was to help identify the epidemiological and prognostic factors in the management of post-traumatic pyothorax in the Thoracic Surgery Department of the Donka National Hospital.</span><b><span style="font-family:Verdana;"> Methodology: </span></b><span style="font-family:Verdana;">This was a descriptive retrospective study covering a period of 2.5 years from 01/06/2016 to 31/12/2018 carried out in the Thoracic Surgery Department of the Donka National Hospital.</span><b><span style="font-family:Verdana;"> Results</span></b><b><span style="font-family:Verdana;" "="">:</span><span "=""> </span></b><span "=""><span style="font-family:Verdana;">During the study period, 17 cases of post-traumatic pyothorax were observed among the 288 files of admitted and hospitalized patients. In the course of this study, a rate was 5.90%. The most affected age group was 1 to 5 years old. The male sex was in the majority (76.5%). The most common occurrence was the fall, </span><i><span style="font-family:Verdana;">i.e.</span></i><span style="font-family:Verdana;"> 41.2%. 47% of patients consult after 60 days. Chest pain and dyspnea were the main symptoms during our study (82.3%). Antibiotics and analgesics dominated the medical treatment used in 100% of the cases and pleural drainage was the first line surgical treatment practiced in 88.2% of the cases. The prognosis is favorable without sequelae in 52.9% of cases with an average hospital stay of 9 days. Post-traumatic pyothorax is a serious pathology involving the vital and functional respiratory prognosis, hence the need to diagnose and treat it early.</span></span>
