What is the treatment for malignant pleural effusion?

Malignant pleural effusion is mostly a malignant manifestation of tumor patients. Patients with this phenomenon are generally weak and suffer from anemia, weight loss and other conditions. To treat malignant pleural effusion, the cause of the disease must be investigated first, because the source must be stopped to prevent the disease from worsening. The effusion can then be removed. Common methods include chest puncture to extract the effusion, or using drugs to relieve the symptoms. For the occurrence of malignant pleural effusion, it is necessary to provide professional treatment promptly and accurately.

Clinical manifestations

Most patients show cachexia symptoms in the late stage of tumor, such as weight loss, emaciation, fatigue, anemia, etc. The patients mainly presented with progressively worsening dyspnea, chest pain and dry cough. The degree of dyspnea is related to the amount of pleural effusion, the speed of pleural effusion formation and the patient's own lung function status. When the amount of effusion is small or forms slowly, the clinical dyspnea is mild, with only chest tightness, shortness of breath, etc. If the amount of effusion is large and the lungs are under obvious pressure, the clinical dyspnea will worsen, and even orthopnea and cyanosis may occur. Patients with a large amount of pleural effusion prefer to lie on the affected side, which can reduce the respiratory movement on the affected side, facilitate compensatory breathing of the healthy lung, and relieve breathing difficulties. Tumor invasion of the pleura, pleural inflammation, and large amounts of pleural effusion causing stretching of the parietal pleura can all cause chest pain, which is often persistent. When the diaphragmatic pleura is invaded, the pain radiates to the affected shoulder blade. Coughs are mostly irritating dry coughs, caused by pleural effusion irritating and compressing the bronchial wall. During physical examination, it can be found that the respiratory movement on the affected side is weakened, the intercostal space is full, the trachea is shifted to the healthy side, the percussion area of ​​the effusion is dull, and the breath sounds disappear.

treat

1. Treatment of the cause

Actively treat the primary disease.

2. Drain the effusion

A small amount of effusion can be left untreated and allowed to be absorbed naturally. If the effusion is moderate or above and there are compression symptoms, thoracentesis should be performed to extract the effusion 2 to 3 times a week. The amount of fluid drawn should not be too much or too fast to prevent pleural shock and ipsilateral expansive pulmonary edema.

3. Drug Injection

Cancerous pleurisy can be treated with injection of anticancer drugs, or injection of tetracycline after complete drainage, to produce chemical stimulation and adhesion to alleviate the compression symptoms caused by the rapid growth of malignant pleural effusion.

4. Pleural tube drainage

When repeated aspiration of malignant pleural effusion is ineffective, a thin catheter can be inserted for closed drainage. After complete drainage within about 72 hours, the above-mentioned drugs can be injected.

5. Surgery

For patients who do not respond to conservative treatment, surgical treatment and pleural adhesion surgery can be considered.