The treatment of malignant pleural effusion

By | April 9, 2012

Malignant pleural effusion is usually surgery is not a sign of advanced disease, cure, treatment, the main purpose is to alleviate the symptoms can be divided into two kinds of systemic therapy and local treatment. When the effective systemic treatment is no longer possible or repeated systemic treatment previously is no longer valid cases, by local treatment is still necessary for palliative effect.
Local treatment only to control the pleural effusion. In the Western treatment of malignant pleural effusion in, the use of pumping or drainage (installed drainage) approach, for emergency treatment, but because of protein antibodies, immune cells, glucose, trace elements and other useful components and the loss of a large number of wear and tear, so that patients sharp decline in weight, resulting in weakness, while resulting in greater pumping fluid, the more pumping more grow faster, the symptoms worsened. Mostly in the chest after the first 1-3 days of wearing a reunion, and anti-pleural puncture fluid easily lead to infection, pleural effusion parcels and hypoproteinemia.
Pleural effusions by closed drainage, it is possible that the pleural cavity is closed within a few days, so that exudate few weeks or months to improve. In general, the only solution or with pleural puncture closed drainage of pleural cavity alone, often not as good as with cytotoxic drugs or integrated application of effective hardening agent. Planted by the pleural effusion caused most to be produced by the intraluminal administration pleural adhesions, the pleural cavity is closed, and then have to stay together again to eliminate the possibility of pleural effusion.
The main side effects were nausea, vomiting, accompanied by chest pain, fever, low white blood cell count less. Pleural thickening agents such as A flat, tetracycline, talc also have some effect.
In recent years, a series of biological effects of regulator used in succession the treatment of malignant pleural effusion, such as Corynebacterium, Corynebacterium anaerobic, Sapylin, CWS, etc., the initial clinical results were satisfied.
Mediastinal tumor or lymph node enlargement caused the center of the pleural effusion is better with radiation, especially radiation sensitive tumors, such as malignant lymphoma, or central lung cancer. Lymphoma refractory to chemotherapy symptoms caused by pleural effusion should be matched selection of radiotherapy. Ineffective treatment of patients with a small number of the above can be used for resection of the pleura, but should be strictly selected cases. Patients with malignant pleural effusion overall prognosis is poor, cases of solid tumors, the average survival of about 6 months, malignant lymphoma by up to 16 months.
The treatment of malignant pleural effusion in clinical, we often use the swollen disease pill to eliminate the abdominal cavity, pleural effusion, while according to the specific circumstances of different patients and disease, respectively, in different ways, medication pleural effusion, ascites, pericardial effusion, limb edema, and achieved good results.

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