Empyema with high mortality, complications and treatment costs. Many therapies for treatment of empyema to help clinicians choose the optimal treatment. The study was to assess the effective treatments of empyema. The results showed that effective treatment: succsess 88.3 percent. 7/60 failure: 6 medical therapy combined drainage (4 operated, 2 septic shock), 1 medical therapy plus drainage combined streptokinase (pleural peel). Effective drain: success 82 percent. 7/39 failure: 6 drainage guided ultrasound. Drainage guided by computerized tomography (CT) had better result than drainage guided by ultrasound. Side effect of streptokinase: fever 76.2 percent; chest pain 66.7 percent; pleural bleeding 9.5 percent; non cases with serious allergy or shock. In conclusion, combined medical treatment and drainage of empyema was effective. Side effect of streptokinase: fever 76.2 percent; chest pain 66.7 percent.
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