包裹性胸腔积液的治疗进展

包裹性胸腔积液作为顽固性胸腔积液的一种,多见于感染性疾病,通常胸腔穿刺难以完全抽取胸腔内积液,且无法对增厚的胸膜进行干预.随着对包裹性积液的深入研究,人们对其病理生理、发生机制有了更深刻的认识.现认为胸腔积液中纤维蛋白的沉积造成了包裹,并且导致胸膜增厚、黏连,胸廓畸形,最终影响肺功能.因此,在治疗基础疾病的基础上尽早充分引流胸腔积液,防止纤维蛋白沉积是预防包裹性胸腔积液的重要措施,而破坏已形成的小房、溶解胸腔内纤维蛋白网则是治疗的重要方法.目前,临床有较多的防治方法,本文综述近年来国内外在治疗方面的研究工作,介绍各种方法及药物在治疗中的作用及存在的不足.

Progression of treatment for loculated pleural effusion

Loculated pleural effusion, one of stubborn pleural effusions is mostly seen in infection diseases. It is not only difficult to aspirate the pleural effusion absolutly through pleural puncturation, but also difficult to intervene the pleura thickening. With the deepening study of the loculated pleural effusion,its pathophysiology and development mechanism have been further known. Now, it is widely accepted that the fibrins in the pleural effusion cause the loculation, the thickening and adhension of the pleura and the malformation of the chest,which eventually affect the lung function. So the key measure for preventing the loculated pleural effusion is to drain the pleural effusion thoroughly as early as possible, prevent the sedimentation of fibrins at the early stage, while destroying the formed loculation and dissolving the fibrin net are important treatment. At present, there are many methods for prevention and treatment in clinic. This review summarizes the research In the field of treatment home and abroad in recent years,and introduces the effects and defects of all kinds of methods and drugs in the course of treatment.