编辑同志:拜读贵刊1992年第19卷5期魏鉴等医师撰写的“粗管闭式引流及胸内药物治疗恶性胸水(附90例报告)”一文(以下简称魏文)受益匪浅,但对其中某些观点不敢苟同,特提出与作者商榷.一、关于胸水引流方法.魏文认为粗管闭式引流法有很大优越性,我们认为此法具有下列缺点:1.对病人损伤大.粗管闭式引流要做7～8cm长切口,同时要切除1.5～2.0cm长的肋骨,无疑会给病人造成较大的损伤.恶性胸水是晚期恶性肿瘤的一种严重并发症,病人一般情况较差,往往伴有其它部位的广泛转移,通常不易治愈,因此对此类病人不宜采取损伤性太大的方法.应积极寻求既能较为彻底地引流胸水,同时创伤性又小的引流方法.2.并发症.魏文治疗的大都是大中量胸水,胸腔压力较高,上述方法不易控制胸水的流出量,如果一次排液过 Editor comrades: After reading the article “Concentrated Closed Tube Drainage and Thoracic Drug Therapy for Malignant Hydrothorax (A Report of 90 Cases)” written by Wei Jian et al (1992), Volume 19, Issue 5 (hereinafter abbreviated as “Wei Wen”), you have benefited greatly. However, some of them did not dare to agree, and proposed to discuss with the author. First, on the pleural drainage method. Wei Wen that closed tube drainage method has a great advantage, we believe that this method has the following shortcomings: 1. For the patient Injury is large. Closed tubular drainage should be done with a 7 to 8 cm long incision. At the same time, 1.5 to 2.0 cm long ribs should be removed, which will undoubtedly cause more damage to the patient. Malignant pleural effusion is a serious complication of advanced malignant tumors. The patient’s general condition is poor, often accompanied by extensive metastasis of other sites, and is usually not easy to cure. Therefore, it is not advisable to adopt too injurious methods for such patients. It should actively seek to drain pleural effusion more thoroughly and be less invasive at the same time. Drainage methods. 2. Complications. Wei Wen treatment is mostly large and medium-sized pleural effusion, chest pressure is higher, the above method is not easy to control the outflow of pleural effusion, if a drainage