Respiratory Medicine, Oxford University Hospitals, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, Great Britain.
Respiratory Medicine, Oxford University Hospitals, Churchill Hospital, Old Road, Headington, Oxford OX3 7LE, Great Britain.
Clin Chest Med. 2018 Mar;39(1):181-193. doi: 10.1016/j.ccm.2017.11.004. Epub 2017 Dec 13.
Malignant pleural effusion is a common complication of cancer and denotes a poor prognosis. It usually presents with dyspnea and a unilateral large pleural effusion. Thoracic computed tomography scans and ultrasound are helpful in distinguishing malignant from benign effusions. Pleural fluid cytology is diagnostic in about 60% of cases. In cytology-negative disease, pleural biopsies are helpful. Current management is palliative. Previously, first-line treatment for recurrent symptomatic malignant pleural effusion was chest drain insertion and talc pleurodesis, with indwelling pleural catheter insertion reserved for patients with trapped lung or failed talc pleurodesis. However, catheter insertion is an increasingly acceptable first-line treatment.
恶性胸腔积液是癌症的常见并发症，预示着预后不良。它通常表现为呼吸困难和单侧大量胸腔积液。胸部计算机断层扫描和超声有助于区分恶性和良性胸腔积液。胸腔积液细胞学检查在约 60%的病例中有诊断价值。在细胞学阴性的疾病中，胸膜活检有帮助。目前的治疗方法是姑息性的。以前，复发性有症状的恶性胸腔积液的一线治疗是胸腔引流管插入和滑石粉胸膜固定术，留置胸腔导管插入术保留给有肺不张或滑石粉胸膜固定术失败的患者。然而，导管插入术越来越被认为是一种可接受的一线治疗方法。
