Abstract:

Objective

To analyze the influencing factors of pulmonary reexpansion after chronic tuberculous empyema operation.

Methods

A total of 73 patients with chronic tuberculous empyema treated in our hospital from January 2019 to September 2023 were selected as the subjects，followed up for 6 months，56 cases with complete pulmonary reexpansion were the control group，and 17 cases with partial pulmonary reexpansion and no pulmonary reexpansion were the observation group.By comparing the two groups of general data，Logisic regression model was used to analyze the influencing factors of pulmonary reexpansion in chronic tuberculous empyema.ROC curve was used to predict pulmonary reexpansion of chronic tuberculous empyema.

Results

The body mass index （BMI） of the observation group （18.54±1.50）kg/m² was lower than that of the control group （20.08±1.97） kg/m².In the observation group，8 patients （47.06%） had a history of smoking and acid-fast bacilli.Sputum culture positive 9 cases （52.94%），AFB pleural effusion culture positive 4 cases（23.53%），operation time （4.16±0.49）h，C-reactive protein （40.21±2.24）g/L were higher than the control group in 7 cases （12.50%），AFB sputum culture positive 7 cases（12.50%），AFB Pleural effusion culture was positive in 3 cases （5.36%），operative time （3.66±0.44）h，C-reactive protein （38.10±1.98）g/L （P＜0.05）；Multivariate Logistic regression analysis showed BMI （OR：0.063，95%CI：0.006-0.641），smoking history（OR：5.320，95%CI：1.148-24.645），AFB sputum culture （OR：10.856，95%CI：1.593-73.987），AFB pleural effusion culture （OR：2.568，95%CI：1.031-6.397），C-reactive protein （OR：4.704，95%CI：1.274-17.359），operation time （OR：9.895，95%CI：1.457-67.191） was the influential factor of poor pulmonary reexpansion after chronic tuberculous empyema operation （P＜0.05）.ROC curve showed that BMI，smoking history，positive proportion of AFB sputum culture，AFB pleural effusion culture，operation time and C-reactive protein in the diagnosis of chronic tuberculous chest abscess postoperative poor lung reexpansion area under curve，AUC was 0.739，0.673，0.702，0.591，0.765，0.789.

Conclusion

BMI，smoking history，positive proportion of AFB sputum culture，AFB pleural effusion culture，operation time and C-reactive protein are the influential factors of lung reexpansion after chronic tuberculous empyema operation.

Key words: Chronic tuberculous empyema, Pulmonary reexpansion, C-reactive protein, AFB sputum culture, AFB pleural effusion culture