Bacon B R, Bailey-Newton R S, Connors A F
Gastroenterology. 1985 Jun;88(6):1910-4. doi: 10.1016/0016-5085(85)90018-6.
The prevalence of pleural effusions after endoscopic variceal sclerotherapy was reviewed in 30 patients undergoing 65 sclerotherapy sessions. Pleural effusions were identified radiographically after 31 of the 65 (48%) sclerotherapy sessions. Eleven of the effusions were right-sided, 10 were left-sided, and 10 were bilateral. Most of the effusions (20 of 31, 65%) were small. Significant postsclerotherapy chest pain was found more commonly in those patients who developed pleural effusions (11 of 31, 35%) compared with those who did not (4 of 34, 12%) (p less than 0.05). The total sclerosant volume injected was significantly greater in those who developed effusions (13.2 +/- 5.8 ml) (mean +/- SD) than in those who did not (8.5 +/- 4.5 ml) (p less than 0.001). Twelve effusions were analyzed biochemically after thoracentesis. Eleven effusions met one or more of three criteria commonly used to identify exudative effusions. We conclude that pleural effusions develop frequently after sclerotherapy. The effusions are predominantly exudative in character and presumably arise from inflammation of the mediastinal parietal pleura.
对30例接受65次硬化治疗的患者进行回顾，以研究内镜下静脉曲张硬化治疗后胸腔积液的发生率。在65次硬化治疗中的31次（48%）后通过影像学检查发现胸腔积液。其中11例积液在右侧，10例在左侧，10例为双侧。大多数积液（31例中的20例，65%）较小。与未发生胸腔积液的患者（34例中的4例，12%）相比，发生胸腔积液的患者更常出现硬化治疗后明显胸痛（31例中的11例，35%）（P<0.05）。发生积液的患者注射的硬化剂总量（13.2±5.8ml）（平均值±标准差）明显多于未发生积液的患者（8.5±4.5ml）（P<0.001）。12例积液在胸腔穿刺后进行了生化分析。11例积液符合常用于识别渗出性积液的三项标准中的一项或多项。我们得出结论，硬化治疗后胸腔积液频繁发生。积液主要为渗出性，推测源于纵隔胸膜壁层的炎症。
