Bratisl Lek Listy. 2022;123(1):50-54. doi: 10.4149/BLL_2022_008.
This narrative review aims to describe and compare different interventional methods for the management of recurrent malignant pleural effusion and offers perspectives for the future era.
Dyspnea as a result of the recurrent malignant pleural effusion is one of the main factors decreasing the quality of life in patients with oncologic diseases. To date, there is no strict guideline for the management of malignant pleural effusions.
Several different techniques are available to prevent production of the effusion or to provide intermittent drainage, however, the principle of these methods remains palliative. The choice of treatment in any patient depends mainly on the preferences of the patient, speed of the fluid production, expandability of the lung, and predicted survival of the patients. The interventional methods of managing malignant pleural effusions are described in detail, including thoracocentesis, chemical pleurodesis, talc poudrage pleurodesis, slurry pleurodesis, thoracoscopic procedures, indwelling pleural catheters, implantable pleural ports, and pleuroperitoneal shunting.
Pleurodesis and fully implantable devices such as pleural ports may become the most useful techniques in the future, mainly because of better comfort for the patients and no need for repeated pleural punctures (Ref. 55).
本文旨在描述和比较复发性恶性胸腔积液的不同介入治疗方法，并为未来提供研究方向。
复发性恶性胸腔积液导致的呼吸困难是降低肿瘤患者生活质量的主要因素之一。迄今为止，尚无恶性胸腔积液管理的严格指南。
目前有多种技术可用于预防胸腔积液的产生或间歇性引流，但这些方法的原理仍然是姑息性的。任何患者的治疗选择主要取决于患者的偏好、液体产生的速度、肺的可扩展性以及患者的预期生存时间。详细描述了管理恶性胸腔积液的介入方法，包括胸腔穿刺、化学胸膜固定术、滑石粉胸膜固定术、滑石粉混悬液胸膜固定术、胸腔镜手术、留置胸腔引流管、植入式胸腔引流端口和胸膜腹腔分流术。
胸膜固定术和完全植入式装置（如胸腔引流端口）可能成为未来最有用的技术，主要是因为这些技术为患者提供了更好的舒适度，且无需进行重复的胸腔穿刺（参考文献 55）。
