Clementsen P, Evald T, Grode G, Hansen M, Krag Jacobsen G, Faurschou P
Department of Pulmonary Medicine, University Hospital, Gentofte, Denmark.
Respir Med. 1998 Mar;92(3):593-6. doi: 10.1016/s0954-6111(98)90315-8.
The aim of this prospective, randomized study was to investigate the possibility of performing pleurodesis using a small percutaneous catheter (Cystofix catheter, CH10, 65 cm) inserted at bedside in patients with recurrent malignant pleural effusion and to compare this catheter with a conventional large bore chest tube (CH24) placed in connection with diagnostic thoracoscopy. After drainage pleurodesis was performed with tetracycline as sclerosing agent. Of 18 evaluable consecutive patients (mean age 67.8 years) nine were randomized for pleurodesis with the small and nine for the large catheter. In the former group, the majority (seven of nine) did not find insertion of the catheter more unpleasant than thoracentesis. In the latter group only a few (two of nine) found insertion comparable with thoracentesis (P < 0.05). All patients found the presence of the large catheter very or somewhat unpleasant (two and seven patients), whereas this was only the case for a few (no and two patients) treated with the small catheter (P < 0.05). In the former group three patients required new thoracentesis, whereas this was only the case for two patients in the latter group (P > 0.05). No complications were seen. We conclude that pleurodesis in patients with recurrent malignant pleural effusion can be performed with a small percutaneous catheter (Cystofix) with an effect similar to that obtained with a large-bore chest tube and with less discomfort for the patient.
这项前瞻性随机研究的目的是探讨在复发性恶性胸腔积液患者床边使用小型经皮导管（Cystofix导管，CH10，65厘米）进行胸膜固定术的可能性，并将该导管与与诊断性胸腔镜检查相关放置的传统大口径胸管（CH24）进行比较。引流后，以四环素作为硬化剂进行胸膜固定术。在18例可评估的连续患者（平均年龄67.8岁）中，9例被随机分配使用小型导管进行胸膜固定术，9例使用大型导管。在前一组中，大多数患者（9例中的7例）认为导管插入并不比胸腔穿刺术更难受。在后一组中，只有少数患者（9例中的2例）认为插入过程与胸腔穿刺术相当（P<０.０５）。所有患者都觉得大型导管的存在非常或有点不舒服（2例和7例患者），而使用小型导管治疗的患者中只有少数（0例和2例患者）有这种情况（P<０.０５）。在前一组中，有3例患者需要再次进行胸腔穿刺术，而在后一组中只有2例患者需要这样做（P>０.０５）。未观察到并发症。我们得出结论，复发性恶性胸腔积液患者可以使用小型经皮导管（Cystofix）进行胸膜固定术，其效果与大口径胸管相似，且患者不适感较轻。
