Bagheri Reza, Noori Marzieh, Rajayi Maryam, Attaran Davood, Mohammad Hashem Asna Ashari Amir, Mohammadzadeh Lari Shahrzad, Basiri Reza, Rezaeetalab Fariba, Afghani Reza, Salehi Maryam
1 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Asian Cardiovasc Thorac Ann. 2018 Jun;26(5):382-386. doi: 10.1177/0218492318778485. Epub 2018 May 23.
Background Malignant pleural effusion continues to be a common problem in patients with metastatic disease. This study was conducted to compare the efficacy and safety of bleomycin pleurodesis with povidone-iodine pleurodesis through a chest drain as palliative treatment for recurrent malignant pleural effusion. Methods Sixty cancer patients (36 males and 24 females) with recurrent malignant pleural effusion were enrolled in a prospective randomized trial. Thirty patients received povidone-iodine pleurodesis and 30 received bleomycin pleurodesis. Age, sex, side of the primary pathology, treatment outcome (recurrence and relapse time), and complications were analyzed. Results The mean age was 59.63 ± 7.68 years in the povidone-iodine group and 57.97 ± 9.27 years in the bleomycin group ( p = 0.452). The complications were identical in both groups: 2 (6.7%) patients had chest pain, 2 (6.7%) had fever, and one (3.3%) had hypotension. There was a good response to therapy in 20 (66.7%) patients in the bleomycin group and 25 (83.3%) in the povidone-iodine group ( p = 0.136). Conclusion The results of this study indicate that povidone-iodine should be considered as a selective chemical agent to perform pleurodesis in patients with recurrent malignant pleural effusion because it has the same effect but costs less than bleomycin.
背景 恶性胸腔积液仍是转移性疾病患者的常见问题。本研究旨在比较通过胸腔引流进行博来霉素胸膜固定术与聚维酮碘胸膜固定术治疗复发性恶性胸腔积液的疗效和安全性。方法 60例复发性恶性胸腔积液的癌症患者（36例男性和24例女性）纳入一项前瞻性随机试验。30例患者接受聚维酮碘胸膜固定术，30例接受博来霉素胸膜固定术。分析年龄、性别、原发病变部位、治疗结果（复发和复发时间）及并发症。结果 聚维酮碘组的平均年龄为59.63±7.68岁，博来霉素组为57.97±9.27岁（p = 0.452）。两组并发症相同：2例（6.7%）患者出现胸痛, 2例（6.7%）发热，1例（3.3%）出现低血压。博来霉素组20例（66.7%）患者治疗反应良好，聚维酮碘组为25例（83.3%）（p = 0.136）。结论 本研究结果表明，聚维酮碘应被视为复发性恶性胸腔积液患者进行胸膜固定术的一种选择性化学药物，因为它具有相同的效果，但成本低于博来霉素。
