Treatment of multilocular encapsulated malignant pleural effusion with urokinase combined with Sapylin

Objective To observe the clinical efficacy and safety of intrapleural injection of urokinase combined with Sapylin in treatment of multilocular encapsulated malignant pleural effusion. Methods Twenty-one cases of multilocular encapsulated malignant pleural effusion underwent firstly percutaneous puncture for introducing central venous catheter which was left in thoracic cavity for continuous drainage of pleural effusion,then transcatheter injection of urokinase 250000U which was reserved for over 4 h,and then drainage continued again. These procedures were repeated for 3-5 times. 10 KE of Sapylin was injected through the catheter into thoracic cavity after the pleural effusion was drained and the lung was reexpanded completely as far as possible. The patients bodies were rotateed every 10-15min in bed without pillows for a total of 3 cycles. The Sapylin was reserved for 24 h,then drainage continued again. The procedures of injec-tion of Sapylin were also repeated for 2-3 times. Results After injection of urokinase,the drainage could be easy and the lung could reexpand completely. The effective rate was 100% . Five cases( 23. 8% ) had transi-ent bloody pleural effusion or the color of original bloody pleural effusion deepened,but no systemic bleeding. One case( 4. 8% ) had moderate fever which subsided 1d after treatment. After injection of Sapylin,16 cases showed CR,3 cases PR,and 2 cases NC. Total effective rate of controlling pleural effusion was 90. 5% . Fourteen cases( 66. 7% ) had low to moderate fever for 2-10 d,5 cases( 23. 8% ) had mild chest pain whichwas controlled by Xingguangpian or indomethacin suppository. Conclusions Treatment of multilocular en-capsulated malignant pleural effusion with urokinase combined with Sapylin was obviously effective and had mild adverse reaction. It is worthy of clinical application.