CAJ | 학술논문

背景：胸腔镜胸膜固定为恶性胸腔积液公认的积极有效治疗手段，硬化剂的优劣直接关系胸膜固定的成功与否，关系到术后的恢复。目的：探讨滑石粉法胸腔镜胸膜固定在顽固性恶性胸腔积液治疗中的作用。方法：纳入顽固性恶性胸腔积液患者29例，其中男14例，女15例，年龄38-79岁，在双腔气管插管静脉复合麻醉下行胸腔镜胸膜固定，硬化剂选择无菌滑石粉，术后观察不良反应情况，术后1个月检查胸部CT，观察胸水量。结果与结论：29例术后均出现胸痛，自行缓解18例，需口服曲马多治疗患者8例，需口服吗啡或注射杜冷丁或吗啡患者3例。术后3 d出现发热者3例。全组无肺水肿、急性呼吸窘迫综合征等严重并发症发生，无死亡病例。术后1个月，治疗有效24例，显效3例，无效2例，总有效率为93%。表明滑石粉法胸腔镜胸膜固定为治疗顽固性恶性胸腔积液一种积极有效的手段。
배경：흉강경흉막고정위악성흉강적액공인적적겁유효치료수단，경화제적우렬직접관계흉막고정적성공여부，관계도술후적회복。목적：탐토활석분법흉강경흉막고정재완고성악성흉강적액치료중적작용。방법：납입완고성악성흉강적액환자29례，기중남14례，녀15례，년령38-79세，재쌍강기관삽관정맥복합마취하행흉강경흉막고정，경화제선택무균활석분，술후관찰불량반응정황，술후1개월검사흉부CT，관찰흉수량。결과여결론：29례술후균출현흉통，자행완해18례，수구복곡마다치료환자8례，수구복마배혹주사두랭정혹마배환자3례。술후3 d출현발열자3례。전조무폐수종、급성호흡군박종합정등엄중병발증발생，무사망병례。술후1개월，치료유효24례，현효3례，무효2례，총유효솔위93%。표명활석분법흉강경흉막고정위치료완고성악성흉강적액일충적겁유효적수단。
BACKGROUND:Although thoracoscopy with pleurodesis is regarded as a positive and effective way for the treatment of malignant pleural effusion, the merit and demerit of sclerosants are directly related to postoperative recovery and the success of pleurodesis. OBJECTIVE:To evaluate the therapeutic effect of talc pleurodesisvia thoracoscopy in the treatment of refractory malignant pleural effusions METHODS:There were 14 male and 15 female patients in this study, age ranging from 38 to 79 years. Al patients with refractory malignant pleural effusion underwent talc pleurodesis under thoracoscopy. The postoperative adverse reactions, chest CT scan 1 month after operation and the fluid drainage were observed. RESULTS AND CONCLUSION:Twenty-nine patients with chest pain were observed in this study. Eighteen patients could relieve the pain itself without medications, eight patients required oral Tramadol and three patients took Demerol or morphine oraly to ease the pain. Fever occurred in three cases at 3 days after operation. Neither pneumonedema, acute respiratory failure, nor death ocurred postoperatively. One month later, complete successful pleurodesis was achieved in 24 cases, and partial successful in 3 cases, and unsuccessful in 2 cases. The results indicate that thoracoscopy with talc pleurodesis can be regarded as a positive and effective way for the treatment of malignant pleural effusion.