Chella A, Ribechini A, Dini P, Adamo C, Mussi A, Angeletti C A
Cattedra e Scuola di Specializzazione di Chirurgia Toracica, Università degli Studi, Pisa.
Minerva Chir. 1994 Nov;49(11):1077-82.
From June 1989 to December 1991, 93 patients affected by malignant pleural effusion (MPE) were treated as out patients using a ultrasound (US) guided catheter drainage (10F Percuflex pig-tail catheter-Medi-tech@(PTC) and chemical pleurodesis. The PTC was positioned when the MPE had been diagnosed by X-ray and all the patients had undergone some thoracentesis (mean 3.2, range 2-6). We started a chemical pleurodesis when the MPE was inferior to 100cc/day injecting Epidoxorubicin (EDX 30 mg/mq) in the pleural space on alternate day for three administrations, and then, a lyophilized Corynebacterium Parvum (Wellcome strain CN 6134) (CBP 14 mg) on alternate day for two administrations. The complete response rate of this treatment was 90% (86 pt) with a mean treatment period of 32.9 days (range 12-62). Complete response was assessed as total resolution of pleural effusion. Side effects were short-term hyperpyrexia in 65 cases (69.8%) and pleurodynia in 15 cases (15.7%). Three patients (3.1%) were complicated by a pleural infection which was resolved in 1 case and became chronic in 2. These findings indicate that this technique is an adequate treatment for the control of MPE inducing a clinical and quality-life improvement.
1989年6月至1991年12月，93例恶性胸腔积液（MPE）患者作为门诊患者接受了超声（US）引导下的导管引流（10F Percuflex猪尾导管 - Medi-tech@（PTC））及化学性胸膜固定术治疗。当通过X线诊断出MPE且所有患者均已接受过多次胸腔穿刺术（平均3.2次，范围2 - 6次）后放置PTC。当MPE每天少于100cc时，开始进行化学性胸膜固定术，在胸腔内隔日注射表柔比星（EDX 30 mg/m²），共注射3次，然后隔日注射冻干短小棒状杆菌（威康菌株CN 6134）（CBP 14 mg），共注射2次。该治疗的完全缓解率为90%（86例），平均治疗周期为32.9天（范围12 - 62天）。完全缓解定义为胸腔积液完全消退。副作用包括65例（69.8%）出现短期高热，15例（15.7%）出现胸膜痛。3例患者（3.1%）并发胸膜感染，其中1例感染得到解决，2例转为慢性。这些结果表明，该技术是控制MPE的一种有效治疗方法，可改善临床症状和生活质量。
