What are the treatment principles for lung abscess

The lungs are important respiratory organs in the human body. Once they become diseased, they have a significant impact on human health. Lung abscess is a disease that is relatively harmful to the body. It is generally caused by tracheal bacterial infection, tracheal obstruction, and weakened body immunity and resistance. Patients with lung abscesses should undergo regular physical examinations and strengthen treatment to better help the body recover.

Causes

The factors that cause lung abscess are bacterial infection, bronchial obstruction, and reduced body resistance. Primary abscesses are caused by aspiration of pathogens or pneumonia, while secondary abscesses are caused by extrapulmonary dissemination, bronchiectasis, and/or immunosuppression on the basis of preexisting lesions (such as obstruction).

treat

The infection foci in the upper respiratory tract and oral cavity must be cured. During oral surgery, secretions should be suctioned out as much as possible. Patients who are in a coma or under general anesthesia should receive enhanced care to prevent lung infections. Early and thorough treatment is the key to curing lung abscess.

The principles of treatment are anti-inflammation and drainage.

1. Antibiotics

The bacteria that infect acute lung abscess, including most anaerobic bacteria, are sensitive to penicillin and have better efficacy, so it is the most commonly used one. The dosage depends on the condition. Generally, acute lung abscess can be cured by penicillin treatment. Bacteroides fragilis is not sensitive to penicillin and can be injected intramuscularly with lincomycin; in severe cases, intravenous drip can be used. Or clindamycin orally. Or metronidazole orally. Erythromycin is effective in treating lung abscess caused by Legionella pneumophila. In addition to systemic medication, local treatment is added, such as cricothyroid membrane puncture, nasal catheter endotracheal or fiberbronchoscope instillation, usually penicillin. After instillation, take an appropriate position according to the location of the abscess and lie still for 1 hour.

Hematogenous lung abscess is a complication of sepsis and should be treated as sepsis.

2. Sputum drainage

Taking expectorants orally can make phlegm easier to cough up. For those with thick sputum, airway humidification methods such as steam inhalation and ultrasonic nebulization inhalation can be used to facilitate the drainage of sputum. If the patient is in generally good condition and has a low fever, postural drainage can help drain the pus. Place the abscess in a high position and pat the affected area gently. If there are obvious signs of sputum obstruction, it can be flushed and suctioned through a fiber bronchoscope.

3. Surgical treatment

Patients with suspected bronchial obstruction or bronchial cancer; patients with chronic lung abscess whose abscess cavity does not shrink and whose infection cannot be controlled after 3 months of medical treatment; or patients with complications such as bronchiectasis, empyema, or bronchopleural fistula; or patients with severe hemoptysis that is life-threatening, require surgical treatment.