Ruckdeschel J C
H. Lee Moffitt Cancer Center, Tampa, Florida.
Oncology (Williston Park). 1992 Feb;6(2 Suppl):119-23.
Spinal cord compression due to epidural metastases, and malignant pleural effusions are devastating complications of advanced cancer that can destroy the quality of a life that is already limited in quantity. Neither need do so. A diagnostic algorithm has been developed for each of these complications. Early diagnosis of cord compression can be accomplished by prompt myelography or magnetic resonance imaging of the affected area of the spine. A malignant pleural effusion, even one that initially appears cytologically negative, can be promptly diagnosed. Radiation and steroids are optimal therapy for most patients with cord compression, and few require surgery. Intrapleural bleomycin appears to be the most effective agent for pleurodesis.
硬膜外转移导致的脊髓压迫和恶性胸腔积液是晚期癌症的毁灭性并发症，会破坏本就时日无多的生活质量。但两者并非一定会如此。针对每种并发症都已制定了诊断算法。通过对脊柱受影响区域及时进行脊髓造影或磁共振成像可实现脊髓压迫的早期诊断。恶性胸腔积液，即使最初细胞学检查呈阴性，也可迅速诊断出来。对于大多数脊髓压迫患者，放疗和类固醇是最佳治疗方法，很少需要手术。胸膜腔内注射博来霉素似乎是胸膜固定术最有效的药物。
