TY - T1的胸腔积液和症状的评估(请)研究患者的呼吸困难的症状性胸腔积液JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.00980 -2019欧元SP - 1900980 AU Muruganandan Sanjeevan AU -泽帕迪,Maree AU -托马斯,Rajesh AU -菲茨杰拉德,迪尔德丽郭鹤年(b . AU -易金盟,他却回族分钟盟——阅读,凯瑟琳a . AU - Budgeon查理a . AU -伊斯特伍德,Peter r . AU -詹金斯,苏珊AU -辛格,祈祷歌AU -穆雷摘要:目前，对胸腔积液相关的病理生理改变、引流及影响症状反应的相关因素了解甚少。我们的目标是确定:i。胸腔积液(及其引流)对心肺、功能和膈肌参数的影响;术后呼吸困难患者的比例及特点。方法对前瞻性纳入的有症状性胸腔积液的患者在治疗前和治疗后24-36小时进行评估。145名参与者完成了前测和后测;93%有渗液≥25%的半胸。排水体积中位数为1.68 L。术后通气评分改善[VAS评分28.0 mm(平均，sd=24);呼吸困难12分10.5分(8.8分); resting Borg score before 6-minute walk test by 0.6 (1.7), all p<0.0001]. 6-minute walk distance increased by 29.7 m (73.5), p<0.0001. Improvements in vital signs and spirometry (FEV1 by 0.22 L [95% CI=0.18–0.27]; FVC by 0.30 L [95% CI=0.24–0.37]) were modest. The ipsilateral hemi-diaphragm was flattened/everted in 50% of participants pre-drainage and 48% exhibited paradoxical or no diaphragmatic movement. Post-drainage, hemi-diaphragm shape and movement were normal in 94% and 73% of participants respectively. Drainage provided meaningful breathlessness relief (VAS score improved ≥14 mm) in 73% of participants, irrespective of whether the lung expanded (mean difference 0.14; 95% CI=10.02–0.29, p=0.13). Multivariate analyses found that breathlessness relief was associated with significant breathlessness pre-drainage (OR=5.83 per sd decrease), baseline abnormal/paralyzed/paradoxical diaphragm movement (OR=4.37), benign etiology (OR=3.39), higher pleural pH and serum albumin levels (OR per sd increase=1.92 and 1.73 respectively).Conclusions Breathlessness and exercise tolerance improved in most patients with only a small mean improvement in spirometry and no change in oxygenation. Breathlessness improvement was similar in participants with and without trapped lung. Abnormal hemi-diaphragm shape and movement were independently associated with relief of breathlessness post-drainage.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr Singh has nothing to disclose.Conflict of interest: Cathy Read has nothing to disclose.Conflict of interest: Dr Kuok has nothing to disclose.Conflict of interest: Dr Jenkins has nothing to disclose.Conflict of interest: Dr Muruganandan has nothing to disclose.Conflict of interest: Dr Thomas has nothing to disclose.Conflict of interest: Dr Eastwood has nothing to disclose.Conflict of interest: Dr Azzopardi has nothing to disclose.Conflict of interest: Dr Murray has nothing to disclose.Conflict of interest: Ms. Cheah has nothing to disclose.Conflict of interest: Dr Lee has nothing to disclose.Conflict of interest: Dr Fitzgerald has nothing to disclose.Conflict of interest: Dr Budgeon has nothing to disclose. ER -