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纤维溶解剂在胸腔感染治疗中的价值

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摘要 胸腔感染是较为常见的临床疾病,目前仍然是感染性疾病中导致死亡的重要原因之一,病死率约为10%-20%。胸腔感染发生后的演变过程可分为3个阶段:(1)渗出期:由于脏层胸膜通透性增高导致少量无菌渗出液的产生;(2)纤维脓性期:由于无菌渗出液发生了致病菌的感染所致,特点是在脏层和壁层胸膜发生纤维蛋白沉积,并引起局部包裹和粘连;(3)机化期:其特点是成纤维细胞生长进入渗出液中,形成失去弹性的纤维板,限制肺脏的运动,明显影响呼吸功能。渗出期胸腔积液常无需引流,有效的抗感染治疗即可痊愈。机化期胸膜腔机化明显,液体减少,常需外科干预(如胸腔镜下或开胸手术行粘连松解术±胸膜剥脱术)。而纤维脓性期(主要包括复杂性肺炎旁胸腔积液和脓胸)的治疗非常关键,治疗原则主要为抗感染治疗以及充分的胸腔引流。
出处 《中华结核和呼吸杂志》 CAS CSCD 北大核心 2013年第5期327-329,共3页 Chinese Journal of Tuberculosis and Respiratory Diseases
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