Multi-factor analysis of the curative effect of thoracic drainage and intrapleural injection of adhesion agent in the treatment of the malignant pleural effusion / 中国基层医药

Objective To study the effect of chest drainage and injection of pleural adhesion agent in the treatment of the malignant pleural effusion (MPE),and to discuss the influences about it.Methods The data of the in-hospital patients with MPE who received thoracostomic drainage and pleural adhesions were retrospectively analyzed.11 factors were selected as research subjects,such as sex,age,KPS score,tissue origin of primary tumor,the position of hydrothorax,the cell number,the level of protein,the level of LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant,the duration between pleurodesis and removing the tude.Then,the factors that affected the effect of pleurodesis were analyzed.Results In total 196 cases,61 patients acquired significant efficacy,71 men achieved good result,and 64 people had no effect.The total effective rate was 67.3％.Univariate analysis showed that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volumeof hydrothorax in 24 hours before using sclerosant were related to the effect.Multivariate Logistic regression analysis indicated that KPS score,tissue origin of primary tumor,the position of hydrothorax,the level of protein and LDH in the effusion,species of sclerosant,the fluid volume of hydrothorax in 24 hours before using sclerosant were indepent factors for efficacy of the pleurodesis.Conclusion It seems that good adhesion effect achieved in patients with MPE that KPS score ≥70,primary breast carcinoma,using sapylin as a sclerosant,the fluid volume of hydrothorax ≤ 200nmL in 24 hours before using sclerosant.

The diagnostic value of transbronchoscopic lung biopsy without X-ray fluoroscopy in patients with perlpheral pulmonary lesions / 中国医师进修杂志

ObjectiveTo investigate the diagnostic value of transbronchoscopic lung biopsy (TBLB) without X-ray fluoroscopy in patients with peripheral pulmonary lesions.Methods Fifty patients with peripheral and diffuse pulmonary lesions and without cavity lesions from January to December 2011 were selected and examined by conventional hronchoscopy.According to the anatomical orientation of CT image and bronchial tree path,TBLB was performed by electronic bronchoscope.ResultsThere were 63 cases of TBLB in 50 patients and 30 patients got confirmed diagnosis (60.0％),including 24 cases in 35patients with peripheral pulmonary lesions (68.6％),and 6 cases in 15 patients with diffuse pulmonary lesions (40.0％).There was no severe complication during and after electronic bronchoscopy.ConclusionsTBLB without X-ray fluoroscopy is a convenient,safe and repeatable operational method with fewer complications.It has higher clinic diagnostic value in pulmonary diseases.