Refractory hepatic hydrothorax has been treated by conservative methods: salt and water restriction, diuretics, thoracentesis, thoracostomy, and pleurodesis. The results, however, havebeen disappointing. Recently, TIPS has emerged as a new method for refractory hepatic hydrothorax, but it may lead to fatal complications. We report a case of refractory hepatic hydrothorax that was not treated by TIPS despite of successful control of ascitest.
Adult ; English Abstract ; Female ; Human ; Hydrothorax/etiology/*therapy ; Liver Diseases/*complications ; Portasystemic Shunt, Transjugular Intrahepatic

Adult ; Female ; Humans ; Hydrothorax ; diagnosis ; etiology ; therapy ; Liver Cirrhosis ; complications ; Male ; Middle Aged ; Talc ; therapeutic use ; Thoracoscopy ; methods

To explore the clinical features, risk factors an d treatment of retinoic acid syndrome (RAS) in patients with acute promyelocytic leukemia (APL) treated with retinoic acid, the clinical and laboratory data of 11 APL patients with RAS were retrospectively analysed. The results showed that earlier and more common symptoms of RAS were successively dyspnea (11/11), fever (10/11) and hydrothorax (6/11). Higher WBC count (> or = 15.0 x 10(9)/L) in the course of treatment of all-trans retinoic acid susceptible to develop RAS (9/11). The RAS patients were treated with dexamethasone without discontinuing the treatment of retinoic acid, complete remission was achieved in 10 cases and one patient died from disseminated intravascular coagulation. It is concluded that the identification and dexamethasone treatment of RAS in earlier period are extremely important for obtaining better clinical curative effect, and it does not influence therapeutic effect of continuing application of retinoic acid.
Adolescent ; Adult ; Child ; Dyspnea ; etiology ; Female ; Fever ; etiology ; Humans ; Hydrothorax ; etiology ; Leukemia, Promyelocytic, Acute ; drug therapy ; Male ; Middle Aged ; Syndrome ; Tretinoin ; adverse effects

Ascites ; diagnosis ; etiology ; therapy ; Diagnostic Imaging ; methods ; Humans ; Hydrothorax ; diagnosis ; etiology ; therapy ; Hypertension, Portal ; complications ; Liver Cirrhosis ; complications ; Liver Transplantation ; Pleural Effusion ; diagnosis ; etiology ; therapy ; Portasystemic Shunt, Transjugular Intrahepatic

OBJECTIVETo investigate the therapeutic effects of Aiyishu Injection (AYSI) on cancerous hydrothorax, quality of life (QOF), and cellular immune function of patients.

METHODSSixty late-stage cancer patients accompanied hydrothorax were randomly divided into the experimental group (EG) and the control group (CG), with thirty patients in each group. After thoracenteses being carried out in all patients for draining off hydropsy, to the patients in EG, AYSI was medicated, 50 ml by intrathoracic and another 50 ml by intravenous injection; while to the patients in CG chemotherapeutic agent or interleukin-2 (IL-2) was given. The same treatment, thoracentesis and medication, was repeated 3 days later. After 4 weeks, the volume of pleural effusion was measured with B-mode ultrasound to evaluate the therapeutic effects of AYSI. QOF, body weight and T-lymphocyte subsets were compared between the two groups before and after treatment.

RESULTSThe clinical efficacy was significantly higher in EG than that in CG (P < 0.01). Besides, QOF was significantly improved (P < 0.05) and levels of CD3+ , CD4+ , CD4+ /CD8+ in peripheral blood increased in EG after treatment, which were significantly different to those in CG (P < 0.01, P < 0.05).

CONCLUSIONAYSI has definite therapeutic effects on cancerous hydrothorax, it could improve QOF and cellular immune function in patients with cancer.

Animals ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; complications ; drug therapy ; Coleoptera ; chemistry ; Humans ; Hydrothorax ; drug therapy ; etiology ; Injections ; Lung Neoplasms ; complications ; drug therapy ; Materia Medica ; therapeutic use ; T-Lymphocyte Subsets ; drug effects ; immunology

OBJECTIVETo study the therapeutic effect and mechanism of thermotherapy combined with thoracic injection of lentinan in treatment of cancerous hydrothorax (CH) in patients with lung cancer.

METHODSSixty lung cancer patients complicated with CH were randomly assigned to the observation group and the control group, 30 in each. CH was released by closed drainage of the thoracic cavity in all patients. Thermotherapy was given to patients in the observation group after lentinan was thoracically injected, while lentinan was thoracically injected to patients in the control group.

RESULTSThe total effective rate of CH improvement was 73.3% (22/30) in the control group and 83.3% (25/30) in the observation group, showing insignificant difference (P>0.05). The stability rate and the weight stability rate by Karnofsky's performance scoring in the observation group were superior to those of the control group, showing significant difference (P<0.05). No hematological reaction, hepatic or renal damage occurred before and after treatment in both groups. Fever, thoracalgia, dyspnea, rash, nausea and vomit appeared in few patients of the two groups, showing insignificant difference (P>0.05). CD3+, CD4+, CD4+/CD8+, and NK obviously increased and CD8+ decreased in the observation group after treatment, showing significant difference from those before treatment (P<0.05). Compared with the control group after treatment, CD3+, CD4+, CD4+/CD8+, and NK obviously increased, CD8+ increased in the observation group (P<0.05).

CONCLUSIONThermotherapy combined with thoracic injection of lentinan showed better effect in treatment of CH in patients with lung cancer. No obvious adverse reaction was seen.

Adult ; Aged ; Biological Products ; therapeutic use ; Combined Modality Therapy ; Female ; Humans ; Hydrothorax ; etiology ; therapy ; Hyperthermia, Induced ; Injections ; Lentinan ; therapeutic use ; Lung Neoplasms ; therapy ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged

BACKGROUND/AIMS: Hepatic hydrothorax in patients with decompensated liver cirrhosis is a challenging problem. Treatment with diuretics and intermittent thoracentesis can be effective in selected patients. However, there are few effective therapeutic options in patients who are intolerant of these therapies. This study investigated the clinical usefulness of chemical pleurodesis with or without video-assisted thoracoscopic surgery (VATS) for patients with refractory hepatic hydrothorax. METHODS: Eleven consecutive patients with refractory hepatic hydrothorax who underwent chemical pleurodesis with or without VATS between July 2007 and February 2011 were enrolled in this study. The medical records and radiologic imagings of these patients were thoroughly reviewed. RESULTS: The median number of chemical pleurodesis sessions performed was 3 (range: 2-10). Successful pleurodesis was achieved in 8 of the 11 patients (72.7%), 5 (62.5%) of whom remained asymptomatic and hydrothorax free for a median follow-up of 16 weeks (range: 2-52 weeks). Complications were low-grade fever/leukocytosis (n=11, 100%), pneumonia (n=1, 9.1%), pneumothorax (n=4, 36.4%), azotemia/acute renal failure (n=6, 54.6%), and hepatic encephalopathy (n=4, 36.4%). Five patients were suspected as having procedure-related mortality (45.5%) due to the occurrence of acute renal failure with hepatic failure. The overall survival was significantly longer in the success group than in the non-success group. CONCLUSIONS: Although chemical pleurodesis may improve the clinical symptoms and the radiologic findings in as many as 72.7% of patients with refractory hepatic hydrothorax, a significantly high prevalence of procedure-related morbidity and mortality hinders the routine application of this procedure for such patients.
Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Hydrothorax/*etiology/mortality/*therapy ; Liver Cirrhosis/*complications/surgery ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Thoracic Surgery, Video-Assisted ; Tomography, X-Ray Computed