Recent advances in parapneumonic effusion and empyema
Recent advances in parapneumonic effusion and empyema
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DOI：
10.1097/01.mcp.0000129755.79467.67
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发表时间：
2004-07-01
影响因子：
3.3
通讯作者：
Davies, RJO
中科院分区：
文献类型：
--
作者：
Chapman, SJ;Davies, RJO
复杂的肺旁积液和肺气肿仍然是重要的发病率和死亡率，其最佳治疗方法仍然不确定。本文综述了该领域的最新进展，以及未来的研究方向。最近的发现最近的进展已经解决了发病机制，细菌学和治疗胸膜感染。脓胸发展的关键研究领域包括炎症和凝血级联反应之间的相互作用以及胸膜腔内纤维化的发展。各种细菌学的脓胸已被更清楚地定义，特别是在社区和医院获得性感染之间的差异突出。治疗的研究特别集中在胸膜内纤溶剂和手术的作用上。对脓胸发病机制的进一步了解可能最终产生新的治疗靶点。对脓肿细菌学的全面描述有助于抗生素的选择，胸膜内dna酶的使用在促进感染胸膜液的引流方面显示出希望。不确定性仍然存在，如胸膜内纤溶的作用和手术干预的最佳时机。
Purpose of reviewComplicated parapneumonic effusion and empyema continue to account for significant morbidity and mortality, and uncertainties remain regarding their optimal management. This review describes recent advances in this field, as well as areas for future research.Recent findingsRecent advances have addressed the pathogenesis, bacteriology, and treatment of pleural infection. Key areas for research in the development of empyema include the interplay between inflammatory and coagulation cascades and development of fibrosis within the pleural space. The varied bacteriology of empyema has been more clearly defined, and in particular the differences between community- and hospital-acquired infection highlighted. Studies of treatment have focused particularly on the roles of intrapleural fibrinolytics and surgery.SummaryIncreased understanding of the pathogenesis of empyema may ultimately yield novel therapeutic targets. Comprehensive descriptions of the bacteriology of empyema aids antibiotic choice, and the use of intrapleural DNase shows promise in facilitating drainage of infected pleural fluid. Uncertainties remain, such as the role of intrapleural fibrinolytics and the optimal timing of surgical intervention.