Lung cancer pleural effusion
Introduction
Introduction Lung cancer pleural effusion is a common complication of patients with advanced lung cancer. It may not affect the quality of life at first. However, as the disease progresses, it may cause symptoms such as dyspnea, cough, chest pain, and the harm to the patient even exceeds the lung cancer itself. Therefore, the elimination of pleural effusion is a top priority for alleviating the suffering of patients with lung cancer. The treatment of lung cancer pleural effusion, Western medicine in the treatment mainly relies on the extraction of pleural effusion, but often it will appear after pumping, it is not easy to completely eliminate the pleural effusion while injecting anticancer drugs, sclerosing agents, immunomodulatory drugs into the chest cavity. The mechanism of addictive drugs is to directly kill cancer cells and slow down the production of pleural effusion in lung cancer. But at the same time, it can cause pleural adhesions, and the effect is not good, which causes the patient's body to be greatly damaged.
Cause
Cause
The cancer of lung cancer patients gradually increases, invading the chest wall tissue to oppress the lung and visceral pleura, affecting the reabsorption of liquid and protein, and the pleural cavity fluid accumulates to form pleural effusion. If not treated in time, the pleural effusion not only produces serious clinical symptoms, but also easily causes the tumor to metastasize and spread quickly.
Examine
an examination
The symptoms of pleural effusion in lung cancer are: the swelling is serious, and the gas is thick and full, and the sputum is full, pink foamy sputum, sitting position, can not lie down, difficulty breathing, visible tri-concavity, the patient is extremely painful, has a sense of death, the condition In a crisis, the water is in the chest and oppresses the lungs.
Diagnosis
Differential diagnosis
1, malignant pleural effusion: refers to the pleural metastasis of malignant tumors or pleural effusion caused by malignant tumors of the pleura. Infection, pain, and pericardial effusion of cancer are common complications of advanced cancer. The reduction of stress-induced atelectasis, restrictive ventilatory disorder, respiratory failure, and decreased blood volume caused by a large amount of pleural effusion seriously affects the respiratory cycle function and directly threatens the patient's life.
2, bloody pleural effusion: refers to the appearance of pleural effusion is obvious blood, more than 15% of the leakage and more than 40% of the exudate can be bloody, red blood cell count between 5000 ~ 100000 / l, only 5000 ~ 10000 / l Red blood cells can make the pleural effusion red, and only 1ml of blood can make 500ml pleural effusion bloody, and red blood cells of gross blood pleural effusion >100000/l. Bloody pleural effusions suggest trauma, malignancy or pulmonary embolism.
3, exudative pleural effusion: a variety of causes of exudative, summarized into two categories: one is caused by inflammatory lesions, such as bacterial, viral or fungal infection of the pleura caused by infectious inflammation, leading to pleural effusion, Or due to pulmonary embolism, pancreatitis, connective tissue disease and other non-infectious inflammation caused by pleural effusion; the second type is neoplastic, such as cancer in the long pleural or metastatic invasion of the pleural effusion, can be seen in pleural mesothelioma, Lung cancer, breast cancer, stomach cancer, etc. The cause of leakage pleural effusion can be systemic diseases, such as hypoproteinemia, allergic diseases, or diseases of certain organs, such as congestive heart failure, cirrhosis, hepatic amebiasis, thoracic duct rupture. Wait.
4, leakage (hydraulic chest) pleural effusion: when congestive heart failure, nephrotic syndrome, cirrhosis and other formation of hypoproteinemia leading to decreased colloid osmotic pressure and water retention caused by pleural effusion; any cause of superior vena cava obstruction Chest leaking effusion occurs; part of the disease causing ascites, lymphatic drainage through the diaphragm of the diaphragm causes pleural effusion. Clinical manifestations include cough, chest swelling, shortness of breath and primary disease. The body has a pleural fluid sign. The pleural effusion is non-transparent and relatively dense.
5, tuberculous pleural effusion: tuberculous pleurisy is the body's highly allergic reaction to tuberculosis protein components, for the primary infection of children and adolescents or secondary tuberculosis involving the chest membrane. Clinical onset can be more urgent, but also slowly, with fever, chest pain, dry cough, fatigue, weight loss, loss of appetite, night sweats and other symptoms of tuberculosis. In the stage of dry pleurisy, chest pain is exacerbated by deep breathing and coughing, and pleural friction sounds are important signs. As the amount of pleural effusion increases, the patient gradually feels shortness of breath. The pleural fluid is grassy yellow transparent or the boat is turbid. It is groundy glass. Compared with the effusion, the effusion can be dark yellow mixed. The relative density of pleural fluid is often above 1.016, and the total number of white blood cells is For 1~2X10/L, the acute phase is mainly neutrophils, while the chronic phase is dominated by lymphocytes, the mesothelial cells are generally less than 1%; the protein content is above 25g/L, and the sugar content is more than 2.8mmol/ Below L; lysozyme and adenylate deaminase in pleural effusion are increased; tuberculosis is easy to find in pleural smear and collecting bacteria, and about one-third of the culture method is positive. For 1/2 cases of pleural biopsy, cheese or non-cheese granulomatous tissue can be seen. When the pleura has inflammatory adhesion, a wrapped pleural effusion can be formed.
