What should I do if the pleural effusion is bloody?

If it is normal, the serous fluid in the pleural membrane should be transparent and play a lubricating role. Pleural effusion is the accumulation of fluid due to pleural lesions or other reasons such as trauma. It is divided into inflammatory and traumatic. The cause of the disease is generally inferred based on the color of the pleural effusion. Bloody pleural effusion is cancerous pleural effusion. So, how should bloody pleural effusion be treated?

The leaked liquid is transparent and clear in appearance, does not solidify when left standing, and has a specific gravity of <1.016~1.018. The exudate is mostly straw yellow and slightly turbid, with a specific gravity >1.018. Purulent pleural effusion often has a foul odor if it is caused by Escherichia coli or anaerobic bacteria infection. Bloody pleural effusion may be meat-washing water or venous blood sample in varying degrees; milky pleural effusion is chylothorax; if the pleural effusion is chocolate-colored, the possibility of amoebic liver abscess rupturing into the chest cavity should be considered; black pleural effusion may be caused by Aspergillus infection.

Bloody pleural effusion is usually seen in lung cancer. Conservative treatment is recommended. If the patient is old, other surgeries or chemotherapy may not be tolerated by the patient. We should try to improve the patient's quality of life and prolong his life.

Malignant pleural effusion Malignant pleural effusion is one of the most common pleural effusions. Among them, metastasis of lung cancer, breast cancer, lymphoma, and ovarian cancer is the most common cause of malignant pleural effusion.

(1) Systemic anti-tumor chemotherapy: Malignant pleural effusion is not limited to the pleural cavity (except for primary pleural malignant tumors). Therefore, for malignant tumors that are more sensitive to systemic anti-tumor chemotherapy, such as small cell lung cancer, malignant lymphoma, breast cancer, etc., the pleural effusion disappears in about 1/3 of patients after systemic chemotherapy.

(2) Local treatment of the thoracic cavity

① Injection of anti-tumor drugs into the pleural cavity: usually intercostal incision and drainage are used to empty the pleural effusion as much as possible, and anti-tumor drugs are injected through the drainage tube, such as cisplatin (cisplatin) 40-80 mg, doxorubicin (adriamycin) 30 mg, mitomycin 10-20 mg, bleomycin 60 mg, 5-fluorouracil (5-fluorouracil) 750-1000 mg, etc., which can not only kill cancer cells, but also cause pleural adhesion.

② Injection of biological immunomodulators into the pleural cavity: such as Corynebacterium brevis (cp), Streptococcus 722 preparation (Sapellin 0K-432), Cytokine, IL-2, interferon, lymphokine-activated killer cells (LAK cells), and tumor infiltrating lymphocytes (TIL).

③ Pleural adhesion surgery: Use tetracycline (<2g each time), talcum powder (<5g each time), doxycycline and other adhesion agents to make the pleura adhere and the pleural cavity closed, preventing the recurrence of pleural effusion.

For intrathoracic injection of anti-tumor drugs or pleural adhesion agents, lidocaine or dexamethasone can be injected at the same time to relieve chest pain or fever. Instruct the patient to rest in bed within 2 hours after injection and change body positions regularly, preferably for 5 to 10 minutes, so that the drug can have extensive contact with the pleura or lesions to achieve the best therapeutic effect.

Comprehensive treatment with traditional Chinese medicine and Chinese herbal medicine can quickly eliminate or control water accumulation, effectively control the disease, alleviate symptoms and pain, etc., so that the patient's condition can be significantly improved in the shortest time and achieve the most ideal effect.

Patients can eat more milk, fruits, vegetables, and chestnuts. Strengthen your physical fitness, exercise more, and choose low-intensity exercises, such as Tai Chi and Qigong, which can improve your resistance. Also, pay attention to the room you live in not being too humid, keep it dry, avoid overeating, seek timely treatment if you get sick, and eat regularly.