Frank W, Grosser H, Mai J, Loddenkemper R
Pneumologie. 1989 Feb;43(2):80-4.
Malignant pleural effusion is a common complication of malignant disease requiring drainage and palliative sclerosing therapy in the vast majority of cases. Tetracycline in conjunction with thoracoscopic drainage is currently considered as the optimal sclerosing agent due to its high efficacy, good patient tolerance, simple and repeatable applicability and low cost of treatment. Traditional and more recent agents like fibrin-sealant may give similar results, but do not achieve a favourable all-round-properties. The relevant data from the literature are reviewed, our own results are presented. An explicit description of pleurodesis is given, also a brief discussion of possible mechanisms of action of sclerosing agents. Concepts are suggested for positioning pleurodesis in the general therapeutic approach to various tumours. The concept of pleurodesis can be similarly successful and safely applied on malignant pericardial effusion (pericardesis).
恶性胸腔积液是恶性疾病的常见并发症，绝大多数情况下需要进行引流和姑息性硬化治疗。四环素联合胸腔镜引流目前被认为是最佳的硬化剂，因为它疗效高、患者耐受性好、操作简单可重复且治疗成本低。传统的和更新的药物如纤维蛋白封闭剂可能会有类似的效果，但不具备良好的综合性能。本文回顾了文献中的相关数据，并展示了我们自己的研究结果。文中对胸膜固定术进行了明确描述，还简要讨论了硬化剂可能的作用机制。文中提出了在各种肿瘤的一般治疗方法中定位胸膜固定术的概念。胸膜固定术的概念同样可以成功且安全地应用于恶性心包积液（心包固定术）。
