Saute M
Department of Cardiothoracic Surgery, Carmel Medical Center, Haifa, Israel.
Isr J Med Sci. 1995 Feb-Mar;31(2-3):160-2.
Malignant pleural effusion is a frequent complication of metastatic breast cancer, leading to a significant degree of morbidity. Drainage of the effusion by thoracocentesis and subsequent pleurodesis is an established means of symptomatic relief in these patients. Several sclerosing agents have been reported in the literature, including doxycylin, minocyclin, tetracyclines, bleomycin, cisplatin, etoposide, fluorouracil, interferon-beta, Corynebacterium parvum, and talc which gives the best results. The condition of the lung's parenchyma must be evaluated prior to the procedure to rule out lymphangitis carcinomatosa or bronchial obstruction that would impair the expansion of the lung. In these situations, the implantation of a pleuroperitoneal shunt is an alternative to be considered.
恶性胸腔积液是转移性乳腺癌常见的并发症，会导致严重的发病率。通过胸腔穿刺术引流积液并随后进行胸膜固定术是缓解这些患者症状的既定方法。文献中报道了几种硬化剂，包括强力霉素、米诺环素、四环素、博来霉素、顺铂、依托泊苷、氟尿嘧啶、干扰素-β、短小棒状杆菌和滑石粉，其中滑石粉效果最佳。在进行该手术前必须评估肺实质的状况，以排除会损害肺扩张的癌性淋巴管炎或支气管阻塞。在这些情况下，可考虑植入胸膜腹膜分流器作为一种替代方案。
