Elpern E H, Krueger J, Kimsey J, Silver M
Illinois Masonic Medical Center, Chicago, USA.
J Crit Illn. 1994 Dec;9(12):1105-10.
Pleurodesis may be indicated for pleural effusions (with careful patient evaluation) or recurrent pneumothoraces. It is contraindicated if tube thoracostomy fails to reexpand the lung and, possibly, if patients are candidates for lung transplantation or have congestive heart failure. We perform pleurodesis through an indwelling chest tube (alternative methods are thoracoscopy and thoracotomy). Common sclerosants include talc, doxycycline, minocycline, and bleomycin. Intrapleural administration of lidocaine may control pain, but injections of morphine or meperidine almost always are needed.
胸膜固定术适用于胸腔积液（需对患者进行仔细评估）或复发性气胸。如果胸腔闭式引流术未能使肺复张，以及（可能）如果患者是肺移植候选者或患有充血性心力衰竭，则禁忌使用胸膜固定术。我们通过留置胸腔引流管进行胸膜固定术（其他方法包括胸腔镜检查和开胸手术）。常用的硬化剂包括滑石粉、强力霉素、米诺环素和博来霉素。胸膜腔内注射利多卡因可控制疼痛，但几乎总是需要注射吗啡或哌替啶。
