Ferreiro Lucía, Suárez-Antelo Juan, Valdés Luis
Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Interdisciplinary Research Group in Pulmonology, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Department of Pulmonology, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Ann Thorac Med. 2017 Jan-Mar;12(1):3-10. doi: 10.4103/1817-1737.197762.
Malignant pleural effusion (MPE) is common in clinical practice, and despite the existence of studies to guide clinical decisions, it often poses diagnostic and therapeutic dilemmas. Once it is diagnosed, median survival does not usually exceed 6 months. The management of these patients focuses on symptom relief since no treatments have been shown to increase survival to date. Conversely, poor management can shorten survival. The approach must be multidisciplinary and allow for individualized care. Initial diagnostic procedures should be minimally invasive and, according to the results and other factors, procedures of increasing complexity will be selecting. Likewise, the treatment of MPEs should be individualized according to factors such as type of tumor, patient functional status, means available, benefits of each procedure, or life expectancy. Currently, treatment seems to tend toward less interventional approaches, in which patients can be managed on an outpatient basis, thus minimizing both the discomfort that more aggressive approaches involve and the costs of care associated with this disease. This article reviews the pleural procedures employed in the management of MPEs with special emphasis on the indication for each one, its usefulness, benefits, and complications.
恶性胸腔积液（MPE）在临床实践中很常见，尽管有研究可指导临床决策，但它常常带来诊断和治疗方面的难题。一旦确诊，中位生存期通常不超过6个月。这些患者的治疗重点是缓解症状，因为迄今为止尚无治疗方法能提高生存率。相反，管理不善会缩短生存期。治疗方法必须是多学科的，并应提供个体化护理。初始诊断程序应微创，根据结果和其他因素，将选择越来越复杂的程序。同样，MPE的治疗应根据肿瘤类型、患者功能状态、可用手段、每种程序的益处或预期寿命等因素进行个体化。目前，治疗似乎倾向于采用较少干预性的方法，患者可在门诊接受治疗，从而将更积极治疗方法带来的不适以及与该疾病相关的护理成本降至最低。本文回顾了用于管理MPE的胸腔操作，特别强调了每种操作的适应症、效用、益处和并发症。
