科研之友
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摘要
objective: to relate the experience of the staff at a health care facility specializing in the management of patients with aspiration lung abscess. methods: diagnostic aspects and therapeutic results of 252 consecutive cases of lung abscess seen in patients hospitalized between 1968 and 2004. results: of the 252 patients, 209 were male, and 43 were female. the mean age was 41.4 years, and 70.2% were alcoholic. cough, expectoration, fever and overall poor health were seen over 97% of patients. chest pain was reported by 64%, 30.2% presented digital clubbing, 82.5% had dental disease, 78.6% reported having lost consciousness at least once, and 67.5% presented foul smelling sputum. in 85.3% of the patients, the lung lesions were located either in the posterior segments of the upper lobe or in the superior segments of the lower lobe, and 96.8% were unilateral. concomitant pleural empyema was seen in 24 (9.5%) of the patients. mixed flora was identified in the bronchopulmonary or pleural secretions of 182 patients (72.2%). all patients were initially treated with antibiotics (mainly penicillin or clindamycin), and postural drainage was performed in 98.4% of cases. surgical procedures were performed in 52 (20.6%) of the patients (drainage of empyema in 24, pulmonary resection in 22 and drainage of the abscess in 6). cure was obtained in 242 patients (96.0%), and 10 (4.0%) died. conclusion: lung abscess occurred predominantly in male adults presenting dental disease and having a history of loss of consciousness (especially as a result of alcohol abuse). most of the patients were treated clinically with antibiotics and postural drainage, although some surgical procedure was required in one-fifth of the study sample.
