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胸腔内注射类固醇治疗复发性恶性胸腔积液：一例报告

Intrapleural Steroid Therapy for Recurrent Malignant Pleural Effusion: A Case Report.

作者信息

Sarker Shima Rani, Faruq Imtiaz, Biswas Jheelam

机构信息

Bangladesh Medical University (BMU) Dhaka Bangladesh.

National Institute of Cancer Research and Hospital (NICRH) Dhaka Bangladesh.

出版信息

Clin Case Rep. 2025 Sep 4;13(9):e70827. doi: 10.1002/ccr3.70827. eCollection 2025 Sep.

DOI:10.1002/ccr3.70827
PMID:40919389
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12411257/
Abstract

Malignant pleural effusion (MPE) is a common complication in advanced cancer, often causing significant dyspnea. We present a case of a 57-year-old woman with recurrent MPE who was managed with intrapleural triamcinolone acetate. The intervention delayed fluid reaccumulation by 15 days and improved her symptoms and functional status, with no adverse effects observed. The proposed mechanism involves VEGF inhibition and reduced vascular permeability. This case highlights intrapleural corticosteroids as a potential palliative option in managing recurrent MPE when conventional treatments are not suitable.

摘要

恶性胸腔积液（MPE）是晚期癌症的常见并发症，常导致严重的呼吸困难。我们报告一例57岁复发性MPE女性患者，采用胸腔内注射醋酸曲安奈德进行治疗。该干预措施使胸腔积液再积聚延迟了15天，改善了她的症状和功能状态，且未观察到不良反应。推测其机制涉及血管内皮生长因子（VEGF）抑制和血管通透性降低。该病例凸显了胸腔内注射皮质类固醇在传统治疗不适用时作为治疗复发性MPE的一种潜在姑息治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/994f132e7668/CCR3-13-e70827-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/5638efd7c79b/CCR3-13-e70827-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/a91bf419e3b6/CCR3-13-e70827-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/994f132e7668/CCR3-13-e70827-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/5638efd7c79b/CCR3-13-e70827-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/a91bf419e3b6/CCR3-13-e70827-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f07f/12411257/994f132e7668/CCR3-13-e70827-g001.jpg

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本文引用的文献

1
Intraperitoneal Steroid Therapy for Recurrent Malignant Ascites in Advanced Cancer Patients: A Case Series.晚期癌症患者复发性恶性腹水的腹腔内类固醇治疗：病例系列
Clin Case Rep. 2024 Dec 26;13(1):e70024. doi: 10.1002/ccr3.70024. eCollection 2025 Jan.
2
Diagnosis and Management of Malignant Pleural Effusion: A Decade in Review.恶性胸腔积液的诊断与管理：十年回顾
Diagnostics (Basel). 2022 Apr 18;12(4):1016. doi: 10.3390/diagnostics12041016.
3
The role of VEGF in the diagnosis and treatment of malignant pleural effusion in patients with non‑small cell lung cancer (Review).
血管内皮生长因子在非小细胞肺癌恶性胸腔积液患者诊断和治疗中的作用（综述）。
Mol Med Rep. 2018 Jun;17(6):8019-8030. doi: 10.3892/mmr.2018.8922. Epub 2018 Apr 23.
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Effectiveness of intraperitoneal or intrapleural administration of triamcinolone acetonide for the control of malignant ascites and pleural effusion (Kansai Clinical Oncology Group-G1102 study).曲安奈德腹腔内或胸腔内给药控制恶性腹水和胸腔积液的有效性（关西临床肿瘤学组-G1102研究）
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Corticosteroids for tuberculous pleurisy.用于结核性胸膜炎的皮质类固醇。
Cochrane Database Syst Rev. 2017 Mar 14;3(3):CD001876. doi: 10.1002/14651858.CD001876.pub3.
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Malignant pleural effusion: from bench to bedside.恶性胸腔积液：从实验台到病床边
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Eurasian J Med. 2009 Dec;41(3):186-93.
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The use of intraperitoneal triamcinolone acetonide for the management of recurrent malignant ascites in a patient with non-Hodgkin's lymphoma.腹腔内注射曲安奈德用于治疗非霍奇金淋巴瘤患者复发性恶性腹水
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A randomized, phase III, double-blind, placebo-controlled trial of intrapleural instillation of methylprednisolone acetate in the management of malignant pleural effusion.一项关于醋酸甲泼尼龙胸膜腔内注射治疗恶性胸腔积液的随机、III期、双盲、安慰剂对照试验。
Chest. 2003 Mar;123(3):822-7. doi: 10.1378/chest.123.3.822.
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Curr Opin Pulm Med. 2002 Jul;8(4):294-301. doi: 10.1097/00063198-200207000-00009.