胸腔闭式引流术治疗肺癌并恶性胸水64例临床分析

Clinical Observation about the Closed Drainage of Pleural Effusion for in Malignant Pleural Effusion of Patients with Lung Cancer

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 explore the value and clinical significance of closed drainage of pleural effusion for malignant pleural effusion. Methods ： 64 patients with lung cancer complicated with malignant pleural were studied and treated by closed drainage of pleural effusion from Nov 2004 to Oct 2012.B ultrasound was performed before pleurocentesise to know the volume and sign the site of puncture.We performed intracavitary administration,some cases were performed intracavitary chemotherapy. The adverse reactions,the symptom of tachypnea,arterial analysis and curative effect of hydrothorax were observed after the treatment two months or hydrothorax disappeared. Results ： Among the 64 cases, there were 3 adverse effects but no serious. After the operation, 58 cases（90.6%） relieved the symptom of tachypnea,38 cases raised the arterial PO2 significantly. Clinical manifestation of hydrothorax was treated better,3 cases did not recur for more than one year. Conclusions ： The closed drainage of pleural effusion is a convenient, safe and effective treatment for patient with lung cancer complicated malignant pleural effusion, the symptom of most cases relieved and a little case have a long time remission.