DIAGNOSIS AND MANAGEMENT OF MALIGNANT PLEURAL EFFUSIONS

被引：128

作者：

FENTON, KN ^{[1
]}

RICHARDSON, JD ^{[1
]}

机构：

[1] UNIV LOUISVILLE,SCH MED,DEPT SURG,LOUISVILLE,KY 40292

来源：

AMERICAN JOURNAL OF SURGERY | 1995年 / 170卷 / 01期

关键词：

D O I：

10.1016/S0002-9610(99)80257-8

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Approximately half of all patients with metastatic cancer develop malignant pleural effusions. Because the patients are already terminally ill, these effusions can present Significant diagnos tic and therapeutic challenges, Symptoms are either present at the time of diagnosis or develop subsequently in virtually all cases. The diagnosis is based on chest radiography followed by thoracentesis or thoracoscopy. Most malignant effusions are exudative and about one third are bloody, Cytology is positive for cancer cells in the initial pleural fluid specimens from 60% of patients who are ultimately shown to have malignant effusions. The remaining 40% require a repeat thoracentesis, pleural biopsy, thoracoscopy, or multiple procedures to prove the presence of cancer, Because the average life expectancy of a patient with a malignant pleural effusion is about 6 months, it is important to ob tain a diagnosis expeditiously and formulate a treatment plan that optimizes quality of life, Tube thoracostomy with chemical pleurodesis using doxycycline or bleomycin is the mainstay of current treatment and is about 85% effective,

引用

页码：69 / 74

页数：6

共 27 条

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