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恶性胸腔积液患者行胸膜固定术后的不良事件

Adverse events after pleurodesis in patients with malignant pleural effusion.

作者信息

Terra Ricardo Mingarini, da Costa Priscila Berenice, Dela Vega Alberto Jorge Monteiro, Pêgo-Fernandes Paulo Manuel

机构信息

Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, SP, Brazil.

Instituto do Cancer do Estado de São Paulo, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.

出版信息

J Thorac Dis. 2020 Jul;12(7):3507-3513. doi: 10.21037/jtd-19-3850.

Abstract

BACKGROUND

Malignant pleural effusion (MPE) is an important sign of advanced disease in metastatic cancer. Pleurodesis is one option to treat recurrent MPE. The Inflammatory response after pleurodesis may lead to important adverse events (AE) in a set of very ill patients.

METHODS

Retrospective analysis of patients submitted to pleurodesis (2009-2013). Clinical and laboratory data were collected. We compare the values in the day of pleurodesis, 2, 5 and 10 days after.

RESULTS

One hundred fourteen patients were undergone to pleurodesis with silver nitrate (46%), iodine (52%) and talc (2%). Female was the most frequent (86%) and the breast cancer was the most common primary site. The most frequent adverse event was low hemoglobin account (37), followed by pain (31). 68% of patients presented AEs and 28% had at least one AE with grade 3 or higher. The most altered was CRP that peaked in the 5 day after pleurodesis. Changes in CRP curve were less severe with the use of iodine when compared with the other two agents.

CONCLUSIONS

Pleurodesis leads to important systemic inflammatory response detected by different serum markers. The occurrence of adverse events in this set of patients was great number of events with being marked as grade 3 or higher.

摘要

背景

恶性胸腔积液(MPE)是转移性癌症晚期疾病的重要标志。胸膜固定术是治疗复发性MPE的一种选择。胸膜固定术后的炎症反应可能会在一组病情非常严重的患者中导致重要的不良事件(AE)。

方法

对接受胸膜固定术的患者(2009 - 2013年)进行回顾性分析。收集临床和实验室数据。我们比较了胸膜固定术当天、术后2天、5天和10天的值。

结果

114例患者接受了硝酸银(46%)、碘(52%)和滑石粉(2%)胸膜固定术。女性最为常见(86%),乳腺癌是最常见的原发部位。最常见的不良事件是血红蛋白计数低(37例),其次是疼痛(31例)。68%的患者出现不良事件,28%的患者至少有一次3级或更高等级的不良事件。变化最明显的是CRP,在胸膜固定术后第5天达到峰值。与其他两种药物相比,使用碘时CRP曲线的变化不太严重。

结论

胸膜固定术会导致不同血清标志物检测到的重要全身炎症反应。这组患者中不良事件的发生率很高,且有大量事件被标记为3级或更高等级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ae6/7399432/4a0676f7a956/jtd-12-07-3507-f1.jpg

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