Mitrofan C, Aldea A, Grigorescu Cristina, Jitaru Iulia, Iosep G, Aramă A, Danciu Cristina-Elena, Bolog S, Mihăescu Tr
Clinica de Chirurgie Toracică, Facultatea de Medicină, Universitatea de Medicină si Farmacie "Gr. T. Popa", Iaşi.
Rev Med Chir Soc Med Nat Iasi. 2005 Oct-Dec;109(4):799-803.
We performed retrospectively study on 136 thoracoscopies done in our clinic in the period January 2000 and December 2004. We reviewed 136 thoracoscopies, 71 patients were male and 65 were female (mean age 58.4 years). Straw colored effusions were present in 78 cases (57%) and hemorrhagic in 58 cases (43%). The surgical procedure consist in diagnostic of thoracoscopy with drainage of pleural effusion, multiply pleural biopsy, pleurodesis and continuous pleural drainage. In our study, the talc powder (5g) was successfully as sclerosing agent. The primary tumor was: lung-63 (46%), breast-26 (19%), mesothelioma-21 (15.5%), stomach-3, ovarian-3, prostate-3, colon-2, lymphoma-1, leukemia-2, plasmocytoma-1 and unknown primary tumor in 11 cases (8%). Adverse effects included-chest pain-35 cases (25%), fever-20 cases (15%), empyema-6 cases (4.5%), prolonged air leak-5 cases (4%), pulmonary infection-2 cases, acute respiratory failure-1 case, malignant invasion of scar-1 patient. For statistical analysis, the success of talc pleurodesis was defined as the absence of pleural fluid on the follow-up chest radiographs. Pleurodesis was successful in 125 cases (92%) of the patients after 1 month-follow-up. Thoracoscopic talc pleurodesis is a safe, economical and effective treatment for malignant pleural effusion.
我们对2000年1月至2004年12月期间在我院进行的136例胸腔镜检查进行了回顾性研究。我们回顾了136例胸腔镜检查病例,其中男性71例,女性65例(平均年龄58.4岁)。78例(57%)出现草黄色胸腔积液,58例(43%)出现血性胸腔积液。手术操作包括胸腔镜诊断及胸腔积液引流、多次胸膜活检、胸膜固定术和持续胸腔引流。在我们的研究中,滑石粉(5g)成功用作硬化剂。原发肿瘤为:肺癌63例(46%)、乳腺癌26例(19%)、间皮瘤21例(15.5%)、胃癌3例、卵巢癌3例、前列腺癌3例、结肠癌2例、淋巴瘤1例、白血病2例、浆细胞瘤1例,11例(8%)为原发肿瘤不明。不良反应包括胸痛35例(25%)、发热20例(15%)、脓胸6例(4.5%)、持续性气胸漏气5例(4%)、肺部感染2例、急性呼吸衰竭1例、瘢痕恶性侵犯1例。为进行统计学分析,滑石粉胸膜固定术的成功定义为随访胸部X线片上无胸腔积液。125例(92%)患者在1个月随访后胸膜固定术成功。胸腔镜滑石粉胸膜固定术是治疗恶性胸腔积液的一种安全、经济且有效的方法。