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目的:探讨胸腔闭式引流术对恶性胸水的治疗价值和临床意义。方法:以2004年11月-2012年10月收治的肺癌并恶性胸水患者64例为研究对象,治疗前均经B超检查以了解胸水量,并标记出参考胸腔穿刺点,并结合胸腔内给药、内科支持治疗等措施,胸水引流干净或治疗后2个月观察评估不良反应及气促症状、血气分析及胸水治疗效果。结果:本组64例患者中,3例发生胸膜不良反应,无1例严重;术后气促症状明显改善者58例(90.6%);术后动脉血氧分压明显改善者38例(59.4%);胸水引流管拔除后胸水得到控制,其中有3例胸水控制达1年以上无复发。结论:胸腔闭式引流术治疗肺癌合并的恶性胸水简便有效,大多数病例可改善气促症状,少部分病例可获长期缓解。
Objective: To investigate the therapeutic value and clinical significance of closed thoracic drainage on malignant pleural effusion. Methods: Sixty-four patients with lung cancer and malignant pleural effusion who were admitted to our hospital from November 2004 to October 2012 were enrolled in this study. All patients underwent B-mode ultrasound before treatment to understand the volume of the pleural effusion and marked the reference thoracentesis. Combined with intrathoracic Medicine, medical supportive treatment and other measures, pleural effusion drainage or 2 months after treatment observed and evaluated adverse reactions and symptoms of shortness of breath, blood gas analysis and pleural effusion treatment. Results: Among the 64 patients in this group, pleural adverse reactions occurred in 3 cases, and none was severe. Fifty-eight patients (90.6%) had postoperative improvement in symptoms of shortness of breath. Postoperative arterial oxygen pressure was significantly improved in 38 patients (59.4 %); Pleural effusion after removal of pleural effusion under control, of which 3 cases of pleural effusion control for more than 1 year without recurrence. Conclusion: Closed thoracic drainage for the treatment of malignant pleural effusion combined with lung cancer is simple and effective. Most cases can improve the symptoms of shortness of breath. In a small number of cases, long-term remission can be achieved.