Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Apr 28, 2017; 9(4): 212-216
Published online Apr 28, 2017. doi: 10.4329/wjr.v9.i4.212
Computed tomography-guided catheter drainage with urokinase and ozone in management of empyema
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu
Bing Li, Chuan Liu, Yang Li, Han-Feng Yang, Yong Du, Chuan Zhang, Hou-Jun Zheng, Xiao-Xue Xu, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Li B and Xu XX designed the study; Li B, Li Y, Zhang C, Liu C and Zheng HJ performed examinations and collected the data; Yang HF, Du Y and Xu XX contributed to the analysis and supervised the report; Li B and Liu C wrote this paper together; Li B, Liu C and Xu XX revised the paper.
Institutional review board statement: This study was approved by the Institutional Review Board of the Affiliated Hospital of North Sichuan Medical College, Department of Radiology - Sichuan Province, China.
Informed consent statement: All patients had given written consent for this study.
Conflict-of-interest statement: All authors have no conflict-of-interest.
Data sharing statement: Participants gave informed consent for data sharing, and no additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xiao-Xue Xu, MD, Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63 Wenhua Road, Nanchong 637000, Sichuan Province, China. littlesnownc@qq.com
Fax: +86-817-2222856
Received: November 5, 2016
Peer-review started: November 8, 2016
First decision: January 16, 2017
Revised: January 31, 2017
Accepted: February 28, 2017
Article in press: March 2, 2017
Published online: April 28, 2017
Processing time: 174 Days and 6.7 Hours
Abstract
AIM

To retrospectively compare the outcomes of catheter drainage, urokinase and ozone in management of empyema.

METHODS

Retrospective study included 209 patients (111 males and 98 females; age range 19 to 72 years) who were diagnosed with empyema. The patients were divided into 3 groups based on the therapy instituted: catheter drainage only (group I); catheter drainage and urokinase (group II); catheter drainage, urokinase and ozone (group III). Drainage was considered successful if empyema was resolved with closure of cavity, clinical symptoms were resolved, and need for any further surgical procedure was avoided. Success rate, length of stay (LOS), need for further surgery and hospital costs were compared between the three groups using the Kruskall-Wallis nonparametric test, with P < 0.05 considered significant.

RESULTS

Of the 209 patients with empyema, all catheters were placed successfully under CT guidance. Sixty-three patients were treated with catheters alone (group I), 64 with catheters and urokinase (group II), and 82 with catheters, urokinase and ozone (group III). Group I, group II and group III had success rates of 62%, 83% and 95% respectively (P < 0.05). Group I and group II had statistically longer LOS (P < 0.05) and higher hospital costs (P < 0.05) compared to group III. There were statistically significant differences between the three groups when comparing patients who converted into further surgery.

CONCLUSION

The combination of chest tube drainage, urokinase and ozone is a safe and effective therapeutic modality in thoracic empyema.

Keywords: Computed tomography-guided; Catheter drainage; Urokinase; Ozone; Empyema

Core tip: The use of ozone as an auxiliary antibacterial agent has achieved a relative good result. CT imaging-based guidance offers precise targeting, which is crucial to the success rates of therapeutic treatment. The combination of chest catheter drainage, urokinase and ozone is a safe and effective therapeutic treatment in thoracic empyema.