Abstract:
Roughly 150,000 malignant pleural effusions (MPE) are diagnosed in the United States each year. The majority of cases are caused by lung and breast cancer, and since MPE represents advanced disease, the prognosis is generally poor. In this article we review the pathophysiology, epidemiology, and prognosis of MPE. We then discuss the approach to diagnosis of MPE including the role of imaging, pleural fluid analysis, and medical thoracoscopy. Current management strategies for symptomatic MPE include repeated thoracentesis for patients with very limited life expectancy as well as more definitive procedures such as chemical pleurodesis, tunneled indwelling pleural catheters, and novel combined approaches. The choice of intervention is guided by the efficacy, local expertise, and risk, as well as patient factors and preferences.
摘要:
在美国每年诊断出大约150,000例恶性胸腔积液(MPE)。大多数病例是由肺癌和乳腺癌引起的,由于MPE代表晚期疾病,预后一般较差。在这篇文章中,我们回顾了病理生理学,流行病学,和MPE的预后。然后我们讨论了MPE的诊断方法,包括影像学的作用,胸腔积液分析,还有内科胸腔镜.目前有症状的MPE的管理策略包括对预期寿命非常有限的患者重复进行胸腔穿刺术,以及更明确的手术,如化学胸膜固定术。隧道留置胸膜导管,和新颖的组合方法。干预的选择以疗效为指导,当地专家,和风险,以及患者因素和偏好。