Pulsiripunya C, Youngchaiyud P, Pushpakom R, Maranetra N, Nana A, Charoenratanakul S
Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Respirology. 1996 Mar;1(1):69-72. doi: 10.1111/j.1440-1843.1996.tb00013.x.
To determine the efficacy of doxycycline in producing pleuroedesis in patients with malignant pleural effusion (MPE), 31 documented cases of MPE, aged 19-82 years were prospectively studied. Pleural sclerosis was done with 500 mg of doxycycline. Response regarding respiratory symptoms and pleural fluid accumulation were evaluated monthly. At one month, 27 patients were evaluable (4 dropped out). All responded and required no therapeutic thoracentesis. At 3 months, 13 patients dropped out, only 14 patients were evaluable. It revealed that 13 out of 14 patients (92%) responded. Only one patient failed and required therapeutic thoracentesis. Five and two patients came for assessment at 6 and 12 months, respectively. They still benefited from doxycycline pleurodesis. Side effects including low grade fever in 30% of patients, moderate to severe pain in 60% and troublesome cough with hemoptysis in one patient (3%) were noted. Doxycycline is an effective agent in controlling MPE. It was successful in every patient at 1 month and in 92% at 3 months. At 6 and 12 months quite a few patients survived for evaluation. However, they still benefited from doxycycline pleurodesis. Side effects were tolerable.
为了确定强力霉素在恶性胸腔积液（MPE）患者中产生胸膜固定术的疗效，对31例年龄在19至82岁之间的MPE确诊病例进行了前瞻性研究。使用500毫克强力霉素进行胸膜硬化治疗。每月评估呼吸症状和胸腔积液积聚情况。1个月时，27例患者可进行评估（4例退出）。所有患者均有反应，无需进行治疗性胸腔穿刺术。3个月时，13例患者退出，仅14例患者可进行评估。结果显示，14例患者中有13例（92%）有反应。只有1例患者无效，需要进行治疗性胸腔穿刺术。分别有5例和2例患者在6个月和12个月时前来评估。他们仍从强力霉素胸膜固定术中获益。观察到的副作用包括30%的患者出现低热，60%的患者出现中度至重度疼痛，1例患者（3%）出现伴有咯血的顽固性咳嗽。强力霉素是控制MPE的有效药物。1个月时在每位患者中均取得成功，3个月时成功率为92%。在6个月和12个月时，有相当多患者存活下来接受评估。然而，他们仍从强力霉素胸膜固定术中获益。副作用是可耐受的。
