Sundaralingam Anand, Grabczak Elzbieta M, Burra Patrizia, Costa M Inês, George Vineeth, Harriss Eli, Jankowska Ewa A, Janssen Julius P, Karpathiou Georgia, Laursen Christian B, Maceviciute Kornelija, Maskell Nick, Mei Federico, Nagavci Blin, Panou Vasiliki, Pinelli Valentina, Porcel José M, Ricciardi Sara, Shojaee Samira, Welch Hugh, Zanetto Alberto, Udayaraj Udaya Prabhakar, Cardillo Giuseppe, Rahman Najib M
Oxford Respiratory Trials Unit, Churchill Hospital, Headington, UK
Oxford Pleural Unit, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Trust, Oxford, UK.
Eur Respir J. 2024 Jul 26;64(6). doi: 10.1183/13993003.02307-2023. Print 2024 Dec.
The incidence of non-malignant pleural effusions far outweighs that of malignant pleural effusions and is estimated to be at least 3-fold higher. These so-called benign effusions do not follow a "benign course" in many cases, with mortality rates matching and sometimes exceeding those of malignant pleural effusions. In addition to the impact on patients, healthcare systems are also significantly affected, with recent US epidemiological data demonstrating that 75% of resource allocation for pleural effusion management is spent on non-malignant pleural effusions (excluding empyema). Despite this significant burden of disease, and by existing at the junction of multiple medical specialties, reflecting a heterogenous constellation of medical conditions, non-malignant pleural effusions are rarely the focus of research or the subject of management guidelines. With this European Respiratory Society Task Force, we assembled a multispecialty collaborative across 11 countries and three continents to provide a statement based on systematic searches of the medical literature to highlight evidence in the management of the following clinical areas: a diagnostic approach to transudative effusions, heart failure, hepatic hydrothorax, end-stage renal failure, benign asbestos-related pleural effusion, post-surgical effusion and nonspecific pleuritis.
非恶性胸腔积液的发病率远高于恶性胸腔积液，估计至少高出3倍。这些所谓的良性积液在许多情况下并非“良性病程”，其死亡率与恶性胸腔积液相当，有时甚至超过恶性胸腔积液。除了对患者的影响外，医疗系统也受到显著影响，美国最近的流行病学数据表明，胸腔积液管理资源分配的75%用于非恶性胸腔积液（不包括脓胸）。尽管疾病负担如此沉重，而且非恶性胸腔积液存在于多个医学专科的交叉领域，反映出一系列不同的医学状况，但它很少成为研究的重点或管理指南的主题。通过欧洲呼吸学会特别工作组，我们在11个国家和三大洲组建了一个多专业协作团队，基于对医学文献的系统检索提供一份声明，以突出以下临床领域管理中的证据：漏出性胸腔积液的诊断方法、心力衰竭、肝性胸水、终末期肾衰竭、良性石棉相关胸腔积液、术后胸腔积液和非特异性胸膜炎。
