DeSouza R, Lipsett N, Spagnolo S V
Chest. 1977 Dec;72(6):782-3. doi: 10.1378/chest.72.6.782.
We describe a patient in whom a malignant pleural effusion accumulated with sufficient pressure to cause mediastinal compression resulting in acute respiratory distress, dysphagia, and massive edema of the lower extremities. Emergency thoracocentesis produced immediate relief to respiratory symptoms and dysphagia, with gradual disappearance of the edema and a weight loss of 6.8 kg (15 lb) without adjunctive medications. It is suggested that thoracocentesis is a life-saving measure in this circumstance and should be done immediately in patients with similar initial clinical findings, as further diagnostic evaluation or other therapy directed to the mediastinum will not releive the tension and will only delay removal of the fluid.
我们描述了一位患者，其恶性胸腔积液积聚，压力足以导致纵隔受压，进而引起急性呼吸窘迫、吞咽困难和下肢重度水肿。紧急胸腔穿刺术立即缓解了呼吸症状和吞咽困难，水肿逐渐消退，体重减轻了6.8千克（15磅），且未使用辅助药物。建议在这种情况下胸腔穿刺术是一种挽救生命的措施，对于有类似初始临床表现的患者应立即进行，因为针对纵隔的进一步诊断评估或其他治疗无法缓解张力，只会延迟液体的排出。
