Storm H K, Viskum K
Bispebjerg Hospital, Lungemedicinsk afdeling P og lungeklinikken København.
Ugeskr Laeger. 1991 Apr 1;153(14):989-92.
Treatment with pleurodesis is employed in spontaneous pneumothorax, in pleural effusion due to neoplastic disease, intractable transudate and chylothorax. When this treatment is employed in spontaneous pneumothorax, randomized studies show a lower recurrence rate when drainage is supplemented by a sclerosing agent. Pleurodesis alone scarcely alters the recurrence rate in pneumothorax. Treatment with pleurodesis is well accepted in malignant pleural effusion. Several randomized studies show a response rate of 11% when thoracocentesis is employed alone whereas a response rate of 40% is obtained when pleural drainage is also employed. When a sclerosing agent is added to pleural drainage, the response rate rises to approximately 60% or more. No randomized studies of pleurodesis in congestive heart failure and chylothorax were found. Pleurodesis is not recommended in the treatment of congestive heart failure because of reports of development of contralateral pleural effusion after successful pleurodesis. In chylothorax, pleurodesis is the last resort.
胸膜固定术用于治疗自发性气胸、肿瘤性疾病引起的胸腔积液、顽固性漏出液和乳糜胸。在自发性气胸的治疗中，随机研究表明，当胸腔引流辅以硬化剂时，复发率较低。单纯胸膜固定术几乎不会改变气胸的复发率。胸膜固定术在恶性胸腔积液的治疗中得到广泛认可。多项随机研究表明，单独进行胸腔穿刺抽液时，有效率为11%，而同时采用胸腔引流时，有效率为40%。当在胸腔引流中添加硬化剂时，有效率可升至约60%或更高。未找到关于胸膜固定术治疗充血性心力衰竭和乳糜胸的随机研究。由于有报道称胸膜固定术成功后对侧出现胸腔积液，因此不建议将胸膜固定术用于充血性心力衰竭的治疗。在乳糜胸的治疗中，胸膜固定术是最后的手段。
