Comparison of efficacy of video-assisted thoracoscopic surgery and chest tube drainage combined with urokinase for the treatment of empyema after fibropurulent pneumonia / 天津医药

ABSTRACT

Objective To compare the clinical effect of video-assisted thoracoscopic surgery (VATS) and chest tube drainage combined with urokinase for the treatment of empyema after fibropurulent pneumonia, and to determine the best therapy for patients. Methods Patients were randomly divided into two groups according to inclusion and exclusion crite?ria55 patients were selected as group VATS performed VATS;46 patients were selected as drainage group performed 12F catheter chest closed drainage by Seldinger technique under B ultrasound guidance. The 100 000 unit urokinase was inject?ed into chest, and open after 4-hour closed, once a day for three days. Values of white blood cell (WBC), pH, glucose, lactate dehydrogenase (LDH) and C reactive protein (CRP) of pleural effusion before treatment were recorded, and the duration of fe?ver after treatment, duration of chest-tube placement, antibiotic use, hospital stay, cure rate, complication and hospitaliza?tion expenses were also recorded. Results The duration of fever after treatment,, duration of chest-tube placement, antibiot?ic use and hospital stay were significantly lower in VATS group than those in drainage group. The cure rate was significantly higher in VATS group than that of drainage group (P<0.05). There were no significant differences in complication rates and hospitalization expenses between two groups. There was no death in both two groups. Conclusion VATS is more suitable for the treatment of empyema after fibropurulent pneumonia than chest tube drainage combined with urokinase, and which is worthy of clinical promotion for not adding complication rates and hospitalization expenses.