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恶性胸腔积液的多学科处理方法:临床医生指南。

Multidisciplinary approaches to the management of malignant pleural effusions: a guide for the clinician.

机构信息

Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust , Oxford, UK.

University of Oxford Respiratory Trials Unit, Churchill Hospital , Oxford, UK.

出版信息

Expert Rev Respir Med. 2020 Oct;14(10):1009-1018. doi: 10.1080/17476348.2020.1793672. Epub 2020 Jul 20.

Abstract

INTRODUCTION

Malignant pleural effusion (MPE) is a complication of advanced cancer, associated with significant mortality and morbidity. This entity is commonly treated by respiratory physicians, oncologists, and thoracic surgeons. There have been various randomized clinical trials assessing the relative merits of chest drain pleurodesis, indwelling pleural catheters, treatment of septated MPEs, the use of thoracoscopy and pleurodesis and pleurodesis through IPCs in the past decade which have addressed some key areas in the management of MPEs, with an increasing focus on patient related outcome.

AREAS COVERED

In this review, we examine and review the literature for management strategies for MPEs and discuss future directions. A detailed search of scientific literature and clinical trial registries published in the past two decades was undertaken.

EXPERT OPINION

Tremendous progress has been made in management of MPE in the past decade and current strategy involves patient preference along with local expertise that is available.

摘要

简介

恶性胸腔积液(MPE)是晚期癌症的一种并发症,与高死亡率和高发病率相关。该病症通常由呼吸科医生、肿瘤学家和胸外科医生治疗。过去十年中,已经进行了多项随机临床试验,评估了胸腔引流胸膜固定术、留置胸腔导管、治疗分隔性 MPE、胸腔镜和胸膜固定术以及通过 IPC 进行胸膜固定术的相对优点,这些试验解决了 MPE 管理中的一些关键领域,并越来越关注患者相关结局。

涵盖领域

在这篇综述中,我们研究和回顾了 MPE 管理策略的文献,并讨论了未来的方向。对过去二十年发表的科学文献和临床试验注册进行了详细搜索。

专家意见

在过去的十年中,MPE 的管理取得了巨大的进展,目前的策略涉及患者偏好以及当地可用的专业知识。

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