a Oxford Respiratory Trials Unit , University of Oxford , Oxford , UK.
b Oxford Centre for Respiratory Medicine , Oxford University Hospitals NHS Trust , Oxford , UK.
Expert Rev Respir Med. 2018 Apr;12(4):323-334. doi: 10.1080/17476348.2018.1445971. Epub 2018 Feb 28.
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice. Expert commentary: Newer methods of achieving pleurodesis are being introduced. Studies have shown that instilling sclerosing agents via an indwelling pleural catheter or introducing drug-eluting catheters are safe and effective ways of inducing pleurodesis. There is evidence that pleurodesis might increase in survival, especially after pleural infection, possibly due to activation of the immune system. Multiple studies are currently underway to answer some of these questions and the future landscape may be very different from the present.
胸膜固定术用于闭塞胸膜腔，最常用于有症状的恶性胸腔积液患者，但也用于良性胸腔积液或气胸患者。涵盖领域：传统上，化学性胸膜固定术是在胸腔镜下进行的，或者通过胸腔引流管灌注混悬液。无论是手术还是药物治疗，实现胸膜固定术的最佳方法尚未得到证实。将审查不同疾病领域的证据，以及正在进行的试验证据，这些证据可能会改变实践。专家评论：正在引入新的胸膜固定术方法。研究表明，通过留置胸膜导管灌注硬化剂或引入载药导管是安全有效的诱导胸膜固定术的方法。有证据表明胸膜固定术可能会增加患者的生存率，特别是在发生胸膜感染后，这可能是由于免疫系统被激活。目前正在进行多项研究来回答其中一些问题，未来的情况可能与现在大不相同。
