Division of Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.
Semin Respir Crit Care Med. 2018 Dec;39(6):713-719. doi: 10.1055/s-0038-1676648. Epub 2019 Jan 14.
Pleural effusions account for significant symptoms and morbidity. Recent studies demonstrate a high mortality in patients with "benign" pleural effusions, now better characterized as nonmalignant pleural effusions (NMPEs) based on their prognosis. The most common nonmalignant clinical conditions with recurrent pleural effusions are congestive heart failure and hepatic hydrothorax, although many other diseases exist in isolation or as comorbid conditions. When conventional therapy fails, thoracentesis is often performed for relief of dyspnea. Many times, however, the effusions recur despite maximal medical therapy. Placement of tunneled or indwelling pleural catheters provides an effective therapeutic strategy for recurrent NMPEs when other medical therapy fails.
胸腔积液可引起明显的症状和发病。最近的研究表明，“良性”胸腔积液患者的死亡率很高，现在根据其预后更好地描述为非恶性胸腔积液 (NMPE)。复发性胸腔积液最常见的非恶性临床情况是充血性心力衰竭和肝性胸水，尽管许多其他疾病孤立存在或作为合并症存在。当常规治疗失败时，常进行胸腔穿刺以缓解呼吸困难。然而，许多时候，尽管进行了最大程度的药物治疗，胸腔积液仍会复发。当其他药物治疗失败时，经皮或留置胸腔导管的放置为复发性 NMPE 提供了一种有效的治疗策略。
