We Tried To Find Out The Clinical Profile Of Chronic Empyema And Its Best Approach To Treat This Disease Entity.
Aims And Objectives- Irrigation via thoracostomy tube of empyema cavity to remove the debris from the pleural space. An approach to prevent extensive surgical operations: e.g. in early tuberculous empyema. To maintain or improve the vital capacity of the encompassed lung by chest physiotherapy. To assess the role of fibrinolytic agents in prevention of chronic empyema.
Material and Methods- The study was carried out in the department of surgery, G.R. Medical College period of 1 YEAR (2011-12) We had studies all patients of chronic empyema admitted during the above mentioned period randomly of all age, Sex. religion, S/E Status and other disease groups. The selection of patient was based on clinical suspicion of empyema thoracis but the diagnosis was always confirmed by radiological and laboratory (including bacteriology) investigations. All the patients were hospital. Some of the patients were referred cases from TB HOSPITAL OF GRMEDICAL COLLGE GWALIOR with or without chest tube in situ. A detailed history was taken, routine and diagnostic investigations were done.
Results- Empyema thoracis was found more commonly in elderly people and preschool children than young adults. Males were affected 4 times as compared to females. Hindus were affected more than other religions possible due to there greater number. Labourers were common victims of empyema. Next to labourers preschool children were commonly affected. The incidence was common in low socio economic status. Higher incidence was found in left side. Duration of Hospital stay was more in patients who admitted with longer duration of symptoms. The common presentation was chest pain, fever, weight loss, wet cough with sings of dull percussion note. anemia, emaciation and chest wall deformity. Family History of PTB was present in 24% of he cases. Majority of patients were either completely immunized or partially immunized in there childhood. The common presentation was of Sub Total unilateral Empyema. Pyogenic empyema was found more number of cases than tubercular, post traumatic and amoebic. Daily irrigation with normal saline and Betadine lotion (week) was found to be effective in about half of the cases. Mortality in this series was 4% all were adults. Lower mortality was seen in children.
rnConclusion- Daily irrigation with normal saline and Betadine lotion (week) was found to be effective in about half of the cases.