胸膜固定术后复发性月经性气胸的药物治疗。
Medical therapy for recurring catamenial pneumothorax following pleurodesis.
作者信息
Dotson R L, Peterson C M, Doucette R C, Quinton R, Rawson D Y, Jones K P
机构信息
Department of Obstetrics and Gynecology, University of Utah, Salt Lake City.
出版信息
Obstet Gynecol. 1993 Oct;82(4 Pt 2 Suppl):656-8.
BACKGROUND
Catamenial pneumothorax, a rare complication of systemic endometriosis, has been difficult to treat successfully. Successful medical therapy is associated with amenorrhea.
CASE
A 44-year-old white woman with recurring catamenial pneumothorax underwent thoracotomy and abrasive pleurodesis. Following the procedures, pneumothorax occurred again and she was treated with the GnRH analogue leuprolide acetate, 3.75 mg monthly intramuscularly. After 6 months, her therapy was changed to continuous hormonal suppression with norethindrone, 0.7 mg/day. After 6 months of this therapy and into the third episode of vaginal bleeding, the patient had another recurrent pneumothorax.
CONCLUSION
Leuprolide acetate followed by continuous hormonal suppression with norethindrone was successful for 1 year in resolving recurring postsurgical catamenial pneumothorax, but the problem recurred with the resumption of vaginal bleeding during progestin therapy. Successful medical therapy requires amenorrhea.
背景
月经性气胸是系统性子宫内膜异位症的一种罕见并发症，一直难以成功治疗。成功的药物治疗与闭经有关。
病例
一名44岁复发性月经性气胸的白人女性接受了开胸手术和胸膜摩擦固定术。术后气胸再次发生，她接受了促性腺激素释放激素类似物醋酸亮丙瑞林治疗，每月肌肉注射3.75毫克。6个月后，她的治疗改为口服炔诺酮持续激素抑制，每日0.7毫克。经过6个月的这种治疗并进入第三次阴道出血期后，患者再次出现复发性气胸。
结论
醋酸亮丙瑞林随后用炔诺酮持续激素抑制在解决术后复发性月经性气胸方面成功了1年，但在孕激素治疗期间随着阴道出血的恢复问题再次出现。成功的药物治疗需要闭经。
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