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[Therapeutic means and methods in recurrent pleurisy]
V Ambăruş1, A Cosovanu, G Ungureanu
1Clinica a III-a medicală, Universitatea de Medicină şi Farmacie Iaşi.
Summary
Recurrent pleural effusion management requires tailored treatments. Pleurodesis, including talc or radiotherapy, is crucial for malignant effusions, while intrapleural cortisone benefits autoimmune cases.
Area of Science:
- Pulmonology
- Oncology
- Internal Medicine
Background:
- Pleural effusion is a common clinical condition.
- Recurrent pleural effusions pose management challenges.
- Thoracentesis can lead to complications like protein and electrolyte depletion.
Purpose of the Study:
- To evaluate treatment strategies for recurrent pleural effusion.
- To determine the efficacy of different interventions based on effusion etiology.
- To highlight the importance of local pathogenic treatments.
Main Methods:
- Retrospective analysis of 960 pleural effusion cases (1981-1991).
- Categorization of effusions into recurrent (20%) and non-recurrent (80%).
- Evaluation of treatment outcomes for malignant and non-malignant recurrent effusions.
Main Results:
- Malignant causes accounted for 40% of recurrent effusions, non-malignant for 60%.
- Intrapleural cortisone effective for autoimmune effusions, ineffective for malignant ones.
- Intrapleural cytostatics, radiotherapy, or talc pleurodesis recommended for malignant effusions.
Conclusions:
- Tailored treatment is essential for recurrent pleural effusion.
- Pleurodesis is a key intervention for malignant and some non-malignant recurrent effusions.
- Pleurosymphysation is contraindicated in terminal heart failure or liver cirrhosis.