Malignant pleural effusion is a common complication of advanced-stage tumors, caused by primary malignant tumors of the pleura or metastasis of malignant tumors to the pleura.
Malignant pleural effusion is most commonly secondary to pleural metastasis, with lung cancer and breast cancer being the most common primary sources, followed by esophageal cancer, lymphoma, and others. Malignant pleural effusion is characterized by a severe condition, poor response to medication, and high recurrence rate. Clinical discovery of malignant pleural effusion often indicates advanced disease stage and low patient survival rate. The focus of treatment is to relieve symptoms, improve quality of life, and prolong survival time. The British Thoracic Society recommends pleurodesis or continuous pleural drainage with drug instillation through a drainage tube for symptomatic patients with malignant pleural effusion, aiming to induce pleural adhesion and ultimately inhibit the formation of pleural effusion. The volume of pleural effusion is often large and rapidly progressing, with clinical manifestations including chest tightness, shortness of breath, and respiratory distress.
A large amount of pleural effusion can also lead to circulatory and respiratory failure, causing a rapid deterioration of the patient’s condition.Therefore, active diagnosis and treatment of malignant pleural effusion are of great significance in gaining opportunities for surgery and chemotherapy, prolonging patient survival, and improving quality of life.
This article is sourced from the Journal of Clinical Ultrasound in Medicine, June 2023, Vol. 25, No. 6, titled “Clinical Value of Ultrasound-guided Pigtail Catheter Drainage for Malignant Pleural Effusion” written by Tang Dachuan and Zhang Wei. DOI:10.16245/j.cnki.issn1008-6978.2023.06.017
ABSTRACT
Objective
To explore the clinical value of ultrasound-guided pigtail catheter drainage in malignant pleural effusion.
Methods
A total of 147 patients with malignant pleural effusion who underwent thoracentesis and catheter drainage in our hospital were selected.They were divided into a control group of 68 cases（using central venous catheter）and a
study group of 79 cases（using pigtail catheter）according to the type of catheter.The placement time，incidence of complications, incidence of catheter displacement，incidence of catheter occlusion and overall effective rate were compared between the two groups.
Results
In the control group，the placement time，incidence of complication，incidence of catheter displacement，incidence of catheter occlusion and overall effective rate were（16.8±1.6）min，1.5%，1.5%，11.8% and 86.8%，respectively.In the study group，the corresponding values were（18.9±2.4）min，1.3%，2.5%，2.5%，94.9%，respectively. There were significant differences in placement time and incidence of catheter occlusion between the two group（both P<0.05）. However，There were no significant differences in incidence of complication，incidence of catheter displacement and overall effective rate.Conclusion
The incidence of catheter occlusion of ultrasound-guided pigtail catheter drainage in malignant pleural effusion is lower than that of central venous catheter，which has better clinical application value.
KEY WORDS
Ultrasound-guided；Pleural effusion，malignant；Pigtail catheter；Central venous catheter
DOI:10.16245/j.cnki.issn1008-6978.2023.06.017