恶性胸腔积液及诊疗策略
Malignant pleural effusion and algorithm management.
作者信息
Zarogoulidis Konstantinos, Zarogoulidis Paul, Darwiche Kaid, Tsakiridis Kosmas, Machairiotis Nikolaos, Kougioumtzi Ioanna, Courcoutsakis Nikolaos, Terzi Eirini, Zaric Bojan, Huang Haidong, Freitag Lutz, Spyratos Dionysios
机构信息
Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
出版信息
J Thorac Dis. 2013 Sep;5 Suppl 4(Suppl 4):S413-9. doi: 10.3978/j.issn.2072-1439.2013.09.04.
Abstract
Involvement of the pleura in lung cancer is a common manifestation accompanying with reduced life expectancy. Symptoms relief and improvement of the quality of life are the primary goals of the management of malignant pleural effusion (MPE). Histological confirmation is essential for optimal patient management. Lung cancer patients, with life expectancy more than 3 months, resistant to chemotherapy should be treated with thoracentesis, intercoastal tube drainage and installation of a sclerosant agent or pleurodesis through thoracospopic procedures or placement of an indwelling pleura catheter. Talc pleurodesis (sterile asbestos-free graded, particle size >15 μm), as "poudrage" or "slurry" still remains the treatment of choice in patients with MPE resistant to chemotherapy.
摘要
胸膜受累在肺癌中是一种常见表现，常伴有预期寿命缩短。缓解症状和提高生活质量是恶性胸腔积液（MPE）治疗的主要目标。组织学确诊对于患者的最佳管理至关重要。预期寿命超过3个月且对化疗耐药的肺癌患者，应采用胸腔穿刺术、肋间置管引流，并通过胸腔镜手术注入硬化剂或进行胸膜固定术，或放置留置胸膜导管。滑石粉胸膜固定术（无菌、无石棉分级，粒径>15μm），作为“粉剂法”或“悬液法”，仍是对化疗耐药的MPE患者的首选治疗方法。
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