Heffner J E, Standerfer R J, Torstveit J, Unruh L
Department of Medicine, St. Joseph's Hospital and Medical Center, Phoenix 85251.
Chest. 1994 Jun;105(6):1743-7. doi: 10.1378/chest.105.6.1743.
To determine the efficacy of doxycycline as a pleural sclerosing agent, we examined the outcomes in 31 patients (aged 31 to 87 years) receiving doxycycline (500 to 1,000 mg) through a chest tube for malignant pleural effusions or persistent bronchopleural fistulae. Of the 27 patients with malignant pleural effusions, 21 patients had a complete short-term response (no fluid reaccumulation during the initial hospitalization); 5 of the 6 short-term nonresponders had partial control of effusions, with improvement in respiratory symptoms. Of the 23 patients who survived longer than 1 month, 15 patients did not have reaccumulation of fluid during follow-up. All four patients with persistent bronchopleural fistulae had resolution of their air leaks; one patient had recurrence with a partial pneumothorax. Pleural pain controllable with narcotic therapy was the only important complication. Thus, doxycycline is a suitable substitute for tetracycline as a pleural sclerosing agent.
为确定强力霉素作为胸膜硬化剂的疗效，我们研究了31例年龄在31至87岁之间、通过胸腔引流管接受强力霉素（500至1000毫克）治疗恶性胸腔积液或持续性支气管胸膜瘘的患者的治疗结果。在27例恶性胸腔积液患者中，21例患者有完全的短期反应（初次住院期间无液体再积聚）；6例短期无反应者中有5例胸腔积液得到部分控制，呼吸症状改善。在存活超过1个月的23例患者中，15例在随访期间无液体再积聚。所有4例持续性支气管胸膜瘘患者的漏气均得到解决；1例患者出现部分气胸复发。需用麻醉治疗控制的胸膜疼痛是唯一的重要并发症。因此，强力霉素是四环素作为胸膜硬化剂的合适替代品。
