Leff A, Hopewell P C, Costello J
Ann Intern Med. 1978 Apr;88(4):532-7. doi: 10.7326/0003-4819-88-4-532.
Pleural effusion from metastatic malignancy can cause major impairment of respiratory function and eventual death. Although cure is not possible, successful palliative treatment allows months to years of productive life, obviating the need for continuous hospitalization and repeated thoracenteses. Successful palliative treatment requires obliteration of the pleural space. Literature survey indicates that a wide variety of medical agents and surgical methods have been used with variable success. Medical methods include instillation of antineoplastic agents, antimicrobial agents, or colloidal radioisotopes into the pleural space; quinacrine and tetracycline are moderately to highly effective agents, but the toxicity of the former is substantial. Bedside talc poudrage with thoracostomy-tube drainage is a safe and highly effective alternative. Pleurectomy is the definitive method of preventing reaccumulation of pleural fluid that results from metastatic malignancy, even when other methods have failed, but thehigh morbidity and mortality of the procedures mandate careful patient selection.
转移性恶性肿瘤引起的胸腔积液可导致呼吸功能严重受损并最终死亡。虽然无法治愈，但成功的姑息治疗可使患者有数月至数年的有意义生活，避免持续住院和反复胸腔穿刺。成功的姑息治疗需要消除胸腔间隙。文献调查表明，已使用多种药物和手术方法，但效果各异。药物方法包括向胸腔内注入抗肿瘤药物、抗菌药物或胶体放射性同位素；奎纳克林和四环素是中度至高度有效的药物，但前者毒性较大。床边滑石粉喷洒加胸腔造瘘管引流是一种安全且高效的替代方法。胸膜切除术是防止转移性恶性肿瘤导致胸腔积液再次积聚的确定性方法，即使其他方法失败时也是如此，但该手术的高发病率和死亡率要求仔细选择患者。
