(胸心外科课件）（参考翻译）10.3 empyema-2017宣讲培训.ppt

* Fibrino purulent stage In this stage a large number of poly-morphonuclear leukocytes and fibrin accumulate in the effusion. Pleural fluid pH and glucose level fall while LDH rises. With continued accumulation of neutro-phils and fibrin, effusion becomes purulent and viscous leading to development of empyema. There is progressive tendency towards loculations and formation of a limiting membranes. Pleural fluid analysis shows purulent fluid or pH less than 7.10, glucose less than 40 mg/dl and LDH more than 1000 IU/L. Gram stain and culture reports show microorganism. * Fibrino purulent stage In this stage a large number of poly-morphonuclear leukocytes and fibrin accumulate in the effusion. Pleural fluid pH and glucose level fall while LDH rises. With continued accumulation of neutro-phils and fibrin, effusion becomes purulent and viscous leading to development of empyema. There is progressive tendency towards loculations and formation of a limiting membranes. Pleural fluid analysis shows purulent fluid or pH less than 7.10, glucose less than 40 mg/dl and LDH more than 1000 IU/L. Gram stain and culture reports show microorganism. As infection goes on there is increasing number of neutriphil infiltration and more and more fibfin exudation, so in the 2nd phase, thr pleural fliud becomes more and more turbid and thick untill it becames frankly pulurent or pus.the lung is compressed by pleural fluid.it is reexpendable in phase 1,but becomes less and less with the deposision of fibrin and fibrin-coating in phase 2. with the lapse of time, there is increasing thickness of fibrin-coatting of lungon both verserral and perietal pleurae, and at the same time,there is fibroblast ingrowth into pleurae producing anelastic membrane the peel or fibrous plate. Thickend preural causes restriction of lung movement and expansion. And also of restriction of chest wall respiratory movemebt. So the respiratory function of the patient becomes much impaired.This is phase 3. the * * (c)