[Successful treatment of thoracic drainage using urokinase for XXXX in an elderly @entity1 ].

@entity1 @entity1143 @entity32 @entity1158 @entity1353 @entity75 @entity3509 @entity262 @entity221 @entity1779 @entity385
A 76-year-old @entity1 was admitted to our hospital because of progressive @entity1353 , @entity221 , and consciousness disturbance. @entity3509 was diagnosed by chest image findings and laboratory findings of @entity1143 and serum. The @entity1 was first given an antimicrobial agent, and chest drainage was performed. Although his general condition improved, his @entity262 @entity32 and chest radiograph findings did not. Then, thoracoscopy under local anesthesia was considered. However, surgery was almost impossible, because he was hemiparetic, with mild conscious disturbance following @entity1779 . We decided to insert another drain into the thoracic cavity and continued to perform irrigation with saline in addition to the @entity262 administration of antibiotics for 3 weeks. His general condition gradually improved. Although the volume of drained fluid from the thoracic cavity decreased, the @entity75 did not completely disappear. We then performed irrigation with saline and urokinase for 3 days, from the 40th hospital day. Irrigation drainage using saline was more effective than previously, before urokinase administration; his symptoms and @entity75 markedly improved without antibiotics treatment. He was discharged on the 95th hospital day. For the treatment of chronic emypema, surgery using recently developed thoracoscopic techniques should be considered first, but may not be appropriate for frail elderly with severe @entity262 complications. Conventional intrathoracic irrigation using saline containing urokinase may be a treatment of choice for intractable @entity3509 in frail older @entity1 with @entity1158 caused by @entity385 .
