重症呼吸治療學題庫下載題庫

纖維胸手術補充如下

Other than physiologic unfitness on the part of the patient, there are no absolute contraindications for decortication. In some patients who also have underlying lung disease, removal of the peel may not help the lung expand, and thus surgery would be futile.

Other conditions that may make decortication futile include the presence of a pleural-space infection and large-airway stenosis. In such cases, the lung will not expand to fill the pleural space.

A more extensive pleuropneumonectomy may be the sole available option, but only if the patient has been worked up preoper...

纖維胸手術補充如下

Other than physiologic unfitness on the part of the patient, there are no absolute contraindications for decortication. In some patients who also have underlying lung disease, removal of the peel may not help the lung expand, and thus surgery would be futile.

Other conditions that may make decortication futile include the presence of a pleural-space infection and large-airway stenosis. In such cases, the lung will not expand to fill the pleural space.

A more extensive pleuropneumonectomy may be the sole available option, but only if the patient has been worked up preoperatively. Pleuropneumonectomy is a major undertaking with a very high mortality.

Decortication may not be possible in the presence of uncontrolled lung infection or contralateral lung disease or for a chronically debilitated patient. Medical optimization may be required before surgery is undertaken in these patients. Ideally, the patient's nutritional status should first be normalized (with nasogastric feedings if necessary), and sepsis should be controlled with appropriate antibiotic therapy.