Light R W, O'Hara V S, Moritz T E, McElhinney A J, Butz R, Haakenson C M, Read R C, Sassoon C S, Eastridge C E, Berger R
Veterans Affairs Medical Center, Long Beach, CA 90822.
JAMA. 1990 Nov 7;264(17):2224-30.
This prospective, multicenter, randomized, "unblinded," controlled clinical trial was designed to determine if the intrapleural instillation of 1500 mg of tetracycline hydrochloride would be effective in diminishing the ipsilateral rate of recurrence for spontaneous pneumothorax. During the 4-year enrollment period, 113 patients were assigned to the tetracycline group; 116 patients were assigned to the control group. During the 5-year study period, the recurrence rate in the tetracycline group (25%) was significantly less than that in the control group (41%). Use of tetracycline seemed to reduce the recurrence rates for patients with either primary or secondary spontaneous pneumothorax and for patients with either an initial or a recurrent pneumothorax. We conclude that the intrapleural administration of tetracycline in patients with spontaneous pneumothorax significantly reduces the rate of ipsilateral recurrence but is associated with intense chest pain. Intrapleural tetracycline therapy is indicated for patients with a spontaneous pneumothorax who are hospitalized and are treated with tube thoracostomy.
这项前瞻性、多中心、随机、“非盲法”对照临床试验旨在确定胸腔内注入1500毫克盐酸四环素是否能有效降低同侧自发性气胸的复发率。在4年的入组期间，113例患者被分配到四环素组；116例患者被分配到对照组。在5年的研究期内，四环素组的复发率（25%）显著低于对照组（41%）。使用四环素似乎能降低原发性或继发性自发性气胸患者以及初发性或复发性气胸患者的复发率。我们得出结论，胸腔内给予四环素可显著降低自发性气胸患者同侧的复发率，但会伴有剧烈胸痛。胸腔内四环素疗法适用于因自发性气胸住院并接受胸腔闭式引流术治疗的患者。
