Yildirim Huseyin, Metintas Muzaffer, Ak Güntülü, Metintas Selma, Erginel Sinan
Osmangazi University, Medical Faculty, Department of Chest Disease, 26480 Meselik, Eskisehir, Turkey.
Lung Cancer. 2008 Oct;62(1):139-44. doi: 10.1016/j.lungcan.2008.02.017. Epub 2008 Apr 9.
Chemical pleurodesis is an accepted palliative therapy for patients with recurrent, symptomatic, malignant pleural effusions (MPE). The purpose of the study was to determine the factors that have an effect on successful pleurodesis for MPE.
Eighty-four consecutive patients with biopsy-proven malignant pleural disease and recurrent, symptomatic MPE were eligible to participate in this study. Five grams of talc mixed in 150ml of normal saline were administered via tube thoracostomy or small-bore catheters after complete drainage of the pleural effusion.
Seven patients did not return for their 30-day follow-up visit and were excluded from further analysis. Successful pleurodesis was achieved in 63 of 77 eligible patients (81.8%) with MPE. In the univariate analysis, female gender, Karnofsky performance status, pleural fluid pH, cholesterol, and adenosine deaminase level showed a significant association with the probability of success. Multivariate logistic regression analysis showed that pleural fluid pH and ADA levels were independent predictors of talc pleurodesis outcome.
Our results show that pleurodesis using talc as the sclerosing agent is a simple and acceptable procedure with high efficacy for controlling MPE, especially when used in appropriate patients.
化学性胸膜固定术是治疗复发性、有症状的恶性胸腔积液（MPE）患者的一种公认的姑息治疗方法。本研究的目的是确定影响MPE胸膜固定术成功的因素。
84例经活检证实为恶性胸膜疾病且有复发性、有症状MPE的连续患者符合本研究的参与条件。在胸腔积液完全引流后，通过胸腔闭式引流管或细导管注入5克滑石粉与150毫升生理盐水的混合液。
7例患者未返回进行30天的随访，被排除在进一步分析之外。77例符合条件的MPE患者中有63例（81.8%）成功进行了胸膜固定术。在单因素分析中，女性、卡诺夫斯基功能状态、胸腔积液pH值、胆固醇和腺苷脱氨酶水平与成功概率有显著相关性。多因素逻辑回归分析表明，胸腔积液pH值和ADA水平是滑石粉胸膜固定术结果的独立预测因素。
我们的结果表明，以滑石粉作为硬化剂的胸膜固定术是一种简单且可接受的方法，对控制MPE具有高效性，尤其是在适用于合适的患者时。
