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[胸腔镜滑石粉胸膜固定术治疗恶性胸腔积液:27例分析]

[Medical thoracoscopic talc pleurodesis for malignant pleural effusion: an analysis of 27 cases].

作者信息

Zhang Wei, Wang Guang Fa, Zhang Hong, Mu Xiang Dong, Jin Zhe

机构信息

Department of Respiratory Medicine, Peking University First Hospital, Beijing, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2008 Dec 18;40(6):600-2.

Abstract

OBJECTIVE

To evaluate the efficacy and safety of talc poudrage pleurodesis via semi-rigid medical thoracoscopy in the treatment of malignant pleural effusions, as well as the factors that may influence the outcomes.

METHODS

A series of 27 patients with malignant pleural effusion underwent medical thoracoscopic talc poudrage pleurodesis between July 2005 and September 2007 in Peking University First Hospital.

RESULTS

There were 16 male and 11 female patients in the series, the average age being 65.2 years. All the patients had documented malignant pleural effusions, including 16 cases of adenocarcinoma, 6 of malignant mesothelioma, 2 of squamous cell carcinoma, 1 of lymphoepithelioma-like carcinoma, 1 of small cell carcinoma and 1 of undifferentiated lung cancer. Thirty days after the procedures, complete successful pleurodesis was achieved in 22 cases, and partial successful in 4 cases. Pleurodesis was not successful in one case. Overall successful rate was 96.3% (26/27). The average duration of thoracic tubing was 6.85 days. Chest pain, fever and an increase in peripheral WBC after the procedure occurred in 19(70.4%, 19/27), 21(77.8%, 21/27), and 12(44.4%, 12/27) cases respectively. No respiratory failure occurred.

CONCLUSION

Medical thoracoscopic talc poudrage pleurodesis is a safe and effective method for the treatment of malignant pleural effusion.

摘要

目的

评估经半硬性内科胸腔镜滑石粉胸膜固定术治疗恶性胸腔积液的疗效和安全性,以及可能影响治疗结果的因素。

方法

2005年7月至2007年9月,北京大学第一医院对27例恶性胸腔积液患者实施了内科胸腔镜滑石粉胸膜固定术。

结果

该组患者中男性16例,女性11例,平均年龄65.2岁。所有患者均确诊为恶性胸腔积液,其中腺癌16例,恶性间皮瘤6例,鳞状细胞癌2例,淋巴上皮瘤样癌1例,小细胞癌1例,未分化肺癌1例。术后30天,22例患者胸膜固定完全成功,4例部分成功,1例失败。总体成功率为96.3%(26/27)。胸腔引流管平均留置时间为6.85天。术后胸痛、发热及外周血白细胞升高分别发生在19例(70.4%,19/27)、21例(77.8%,21/27)和12例(44.4%,12/27)患者中。无呼吸衰竭发生。

结论

内科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有效的方法。

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