红霉素胸膜固定术对难治性胸膜疾病的治疗价值

目的探讨红霉素胸膜固定术对难治性胸膜疾病（恶性胸腔积液、复发性气胸）的治疗价值。方法经胸腔闭式引流管将红霉素0．75～1．0g溶于5％葡萄糖40ml溶液注入到胸膜腔治疗复发性气胸18例，恶性胸腔积液12例为治疗组，以同期14例复发性气胸，10例恶性胸腔积液用胸腔穿刺抽气、抽液和（或）胸腔闭式引流的治疗方法为对照组。结果以红霉素为硬化剂的胸膜固定术治疗30例难治性胸膜疾病均痊愈或好转出院，30例患者均随访，治疗组18例气胸中2例复发，复发率11．1％，较对照组43．3％差异有显著性（P〈0．05）。治疗组12例恶性胸腔积液0．5及1年生存率分别为100％、75％分别高于对照组的60％、20％，两者均有显著性差异（P〈0．05）。结论红霉素可作为一种有效的胸膜硬化剂治疗复发性气胸、恶性胸腔积液。

The value of erythromycin pleurodesis in the treatment of obstinate disease of pleura

Objective To investigate the value of erythromycin pleurodesis in the treatment of obstinate disease of pleura ( malignant pleural effussion and recurrent pneumothorax). Methods A dose of 0..75g to 1.0g erythromycin in 40ml 5% glucose was injected into the pleural cavity of 18 patients with spontaneous pneumothorax and 12 patients with malignant pleural effussion through closed drainage tube of thoracic cavity as treatment group. 14 cases with recurrent pneumothorax and 10 cases with malignant pleural effussion were treated by thoracentesis or closed drainage ofthoracic cavity as control group. Results 30 patients of as treatment group recovered well after being treated by erythromycin as a pleural sclerosant and all of them were followed up. There were statistically significant differences of recurrence rate between 11.1% in treatment group and 43.3% in control group(P<0.05).Six-month and one-year survival rate was 100% and 75% in 12 cases with malignant pleural effusion higher than 60% and 20% in control group. The differences between the groups were all significant(P<0.05). Conclusion This study indicates that erythromycin may have a potential role as a useful pleural sclerosant in treating malignant pleural effussion and recurrent pneumothorax.