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化疗性胸腔积液的成功评估与管理:病例报告及文献综述

Successful Assessment and Management of Chemothorax: A Case Report and Literature Review.

作者信息

Bakali Hassan Edward, Ecer Batuhan Riza, Mammadov Rza, Akcam Tevfik Ilker

机构信息

Thoracic Surgery, Ege University Faculty of Medicine, Izmir, TUR.

出版信息

Cureus. 2025 Jun 23;17(6):e86595. doi: 10.7759/cureus.86595. eCollection 2025 Jun.

DOI:10.7759/cureus.86595
PMID:40704241
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12285612/
Abstract

Chemothorax is a rare complication associated with central venous catheters, caused by the inadvertent infusion of chemotherapy into the pleural space due to catheter malposition. Malignant pleural effusion is a common suspect in oncologic patients; however, alternative causes, such as chemothorax, should also be considered. Few cases have been reported, emphasizing the need for careful catheter placement and early recognition of complications to prevent adverse outcomes. The risk of this complication underlines the need for meticulous catheter placement, routine radiologic verification, and prompt management to prevent serious outcomes in affected patients.

摘要

化学性胸膜炎是与中心静脉导管相关的一种罕见并发症,由导管位置不当导致化疗药物意外注入胸膜腔引起。恶性胸腔积液是肿瘤患者的常见可疑病因;然而,也应考虑其他病因,如化学性胸膜炎。报道的病例很少,这凸显了谨慎放置导管以及早期识别并发症以预防不良后果的必要性。这种并发症的风险强调了需要细致放置导管、进行常规放射学验证以及及时处理,以防止受影响患者出现严重后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/7c5f5a0a807f/cureus-0017-00000086595-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/6acf0f45a86d/cureus-0017-00000086595-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/d0e9a9b0829e/cureus-0017-00000086595-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/7c5f5a0a807f/cureus-0017-00000086595-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/6acf0f45a86d/cureus-0017-00000086595-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/d0e9a9b0829e/cureus-0017-00000086595-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a6e5/12285612/7c5f5a0a807f/cureus-0017-00000086595-i03.jpg

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本文引用的文献

1
Hyperthermic intrapleural chemotherapy: an update.热灌注胸腔内化疗:最新进展
J Thorac Dis. 2023 Sep 28;15(9):5064-5073. doi: 10.21037/jtd-23-454. Epub 2023 Aug 11.
2
Case report: Successful multimodal assessment and management of chemothorax.病例报告:成功进行化学性胸腔积液的多模式评估与管理。
Front Surg. 2022 Jul 26;9:921968. doi: 10.3389/fsurg.2022.921968. eCollection 2022.
3
Malignant Pleural Effusion: Presentation, Diagnosis, and Management.恶性胸腔积液:临床表现、诊断和处理。
Am J Med. 2022 Oct;135(10):1188-1192. doi: 10.1016/j.amjmed.2022.04.017. Epub 2022 May 14.
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Pleural Effusion in Adults-Etiology, Diagnosis, and Treatment.成人胸腔积液:病因、诊断与治疗。
Dtsch Arztebl Int. 2019 May 24;116(21):377-386. doi: 10.3238/arztebl.2019.0377.
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Malignant Pleural Effusion: From Diagnostics to Therapeutics.恶性胸腔积液:从诊断到治疗。
Clin Chest Med. 2018 Mar;39(1):181-193. doi: 10.1016/j.ccm.2017.11.004. Epub 2017 Dec 13.
6
Video-assisted thoracoscopy in the management of intrapleural extravasation of cytotoxic chemotherapy.胸腔镜辅助治疗细胞毒性化疗药物胸腔外渗。
Thorac Cancer. 2017 Jul;8(4):363-364. doi: 10.1111/1759-7714.12430. Epub 2017 Mar 31.
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Interventions for the management of malignant pleural effusions: a network meta-analysis.恶性胸腔积液管理的干预措施:一项网状荟萃分析。
Cochrane Database Syst Rev. 2016 May 8;2016(5):CD010529. doi: 10.1002/14651858.CD010529.pub2.
8
Chemothorax: a rare cause of a transudative pleural effusion.化学性胸腔积液:漏出性胸腔积液的罕见病因。
BMJ Case Rep. 2015 Dec 10;2015:bcr2015212691. doi: 10.1136/bcr-2015-212691.
9
Pseudochylothorax and diaphragmatic weakness secondary to a misplaced central venous catheter.中心静脉导管位置不当继发假性乳糜胸和膈肌无力。
BMJ Case Rep. 2013 Apr 18;2013:bcr2013008765. doi: 10.1136/bcr-2013-008765.
10
Hydrothorax following delayed extravascular migration of a totally implantable venous access device in a child.儿童完全植入式静脉输液港血管外迁移致胸腔积液。
J Pediatr Surg. 2012 Oct;47(10):e1-4. doi: 10.1016/j.jpedsurg.2012.05.014.