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[月经相关性(经期性)气胸和经期咯血]

[Menstruation-associated (catamenial) pneumothorax and catamenial hemoptysis].

作者信息

Hamacher J, Bruggisser D, Mordasini C

机构信息

Pneumologische Abteilung, Tiefenauspital, Bern.

出版信息

Schweiz Med Wochenschr. 1996 May 25;126(21):924-32.

PMID:8693313
Abstract

We report on 2 patients with catamenial pneumothorax and one patient with catamenial hemoptysis. The pathogenesis of these diseases is not clear, and intrathoracic endometriosis is often assumed. Catamenial pneumothorax is rare and differs from primary spontaneous pneumothorax in its prevalence in the fourth decade and in mainly multiparous women, its recurrent and almost exclusively right-sided occurrence within 72 hours of the beginning of menstruation, and the generally small size of the pneumothorax. About 5% of women under 50 presenting with primary pneumothorax have catamenial pneumothorax. Prevention of recurrence is difficult, as the recurrence rate is high, treatment duration is potentially long, and residual thoracic pain during menstruation is sometimes seen. The combination of medication (Gn-RH analogues, danazol, possibly hormonal contraceptive drugs or progestagens) with efficient pleurodesis (e.g. thoracoscopic talc application preferentially performed during menstruation) seems so far to be the most efficient, although no controlled studies have yet been performed. Catamenial hemoptysis is very rare and hormonal treatment alone is frequently successful in the long term. In the event of relapse, resection of the implicated endometriotic or angiomatous lesion localized by computed tomography can be performed.

摘要

我们报告了2例月经期气胸患者和1例月经期咯血患者。这些疾病的发病机制尚不清楚,常假定为胸腔内子宫内膜异位症。月经期气胸较为罕见,与原发性自发性气胸不同,其好发于40岁左右,且多见于经产妇,在月经开始72小时内反复发生且几乎均为右侧气胸,气胸一般体积较小。50岁以下出现原发性气胸的女性中约5%患有月经期气胸。由于复发率高、治疗周期可能较长且有时会出现经期残留胸痛,预防复发较为困难。药物治疗(促性腺激素释放激素类似物、达那唑、可能还有激素避孕药或孕激素)与有效的胸膜固定术(如优先在月经期间进行的胸腔镜滑石粉喷洒)相结合,目前似乎是最有效的方法,不过尚未进行对照研究。月经期咯血非常罕见,长期单独使用激素治疗通常会取得成功。如果复发,可以对通过计算机断层扫描定位的相关子宫内膜异位或血管瘤样病变进行切除。

相似文献

1
[Menstruation-associated (catamenial) pneumothorax and catamenial hemoptysis].[月经相关性(经期性)气胸和经期咯血]
Schweiz Med Wochenschr. 1996 May 25;126(21):924-32.
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