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留置胸腔导管滑石粉胸膜固定术治疗恶性胸腔积液:一种新的临床路径回顾性病例系列研究。

Talc pleurodesis through indwelling pleural catheters for malignant pleural effusions: retrospective case series of a novel clinical pathway.

机构信息

Guy's and St Thomas' NHS Trust, London, England.

Guy's and St Thomas' NHS Trust, London, England.

出版信息

Chest. 2014 Dec;146(6):e190-e194. doi: 10.1378/chest.14-0394.

Abstract

Malignant pleural effusions cause significant morbidity, but there is no gold standard minimally invasive treatment. A new therapeutic approach combines talc pleurodesis and indwelling pleural catheters (IPCs) to enable outpatient management. This case series summarizes the safety and efficacy data of all patients (24) with a symptomatic malignant pleural effusion who underwent talc pleurodeses via IPCs between December 2010 and July 2013. Successful pleurodesis was achieved in 22 procedures (92%). There was one empyema, one hydropneumothorax, one recurrent effusion, and two minor complications: one drain site wound infection and one complaint of chest pain. Twenty-two procedures (92%) were performed in the outpatient setting. This report confirms the safety and efficacy of administering talc slurry through IPCs in an outpatient setting. Studies in a larger cohort are necessary to define the role of this novel approach in the treatment algorithm of patients with this condition.

摘要

恶性胸腔积液会导致严重的发病率,但目前还没有微创治疗的金标准。一种新的治疗方法结合滑石粉胸膜固定术和留置胸膜导管(IPC),以实现门诊管理。本病例系列总结了 2010 年 12 月至 2013 年 7 月期间所有因症状性恶性胸腔积液而行 IPC 滑石粉胸膜固定术的 24 名患者的安全性和疗效数据。22 例(92%)手术成功。有一例脓胸,一例液气胸,一例复发性胸腔积液,两例轻微并发症:一例引流部位伤口感染和一例胸痛投诉。22 例(92%)在门诊进行。本报告证实了在门诊环境下通过 IPC 给予滑石粉混悬液的安全性和有效性。有必要在更大的队列中进行研究,以确定这种新方法在这种情况下的治疗方案中的作用。

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