Estudio de los factores que influyen en la pleurodesis con talco en los derrames pleurales recidivantes
R. Sánchez Gil
Hospital Virgen del Rocío. Sevilla
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"apellidos" => "de Gracia Roldán" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615311315?idApp=UINPBA00003Z" "url" => "/03002896/0000003000000002/v1_201509151209/S0300289615311315/v1_201509151209/es/main.assets" ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "Estudio de los factores que influyen en la pleurodesis con talco en los derrames pleurales recidivantes" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "114" "paginaFinal" => "115" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "R. Sánchez Gil" "autores" => array:1 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Sánchez Gil" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Hospital Virgen del Rocío. Sevilla" "identificador" => "aff0005" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "es" => array:2 [ "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Investigar: <span class="elsevierStyleItalic">1</span>. Qué factores podrían influir en una optimización de la técnica de pleurodesis con talco. <span class="elsevierStyleItalic">2</span>. Qué factores podrían ser de utilidad como predictores de los resultados. <span class="elsevierStyleItalic">3</span>. Evaluar las modalidades técnicas de la pleurodesis con talco.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Pacientes</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Doscientos veinticinco pacientes consecutivos con derrame pleural recidivante. Se perdieron 19 pacientes en el seguimiento.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Métodos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Todos los pacientes fueron sometidos a toracoscopia bajo anestesia local, con realización de pleurodesis con talco y posterior colocación de tubo de drenaje pleural. Los resultados de la pleurodesis se evaluaron como buenos cuando no se registró recidiva del derrame a partir del primer mes tras la toracoscopia.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Éxito completo de la pleurodesis en 160 de los 206 pacientes que pudieron ser evaluados (78%). El derrame se controló además (presencia de pequeño derrame basal, pero sin necesidad de toracentesis evacuadoras) en otro 7% de los pacientes (= 85% de éxitos relativos).</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Parámetros con mayor valor discriminativo respecto a los resultados: pH del líquido pleural (80% de éxitos cuando era superior a 7,20, frente a sólo un 40% cuando era inferior a este nivel, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,03); glucosa (86% de éxitos cuando era superior a 60 mg/dl, frente a sólo 67% cuando era inferior, p < 0,05), y LDH en el líquido pleural (82% de éxitos cuando era inferior a 1.000 U/l, frente a sólo 45% cuando era superior, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,0009).</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La presencia de alta celularidad en el líquido pleural, neutrofilia relativa, glucosa inferior a 60 mg/dl, pH menor de 7,20 y LDH pleural superior a 1.000 U/l son factores de mal pronóstico para la pleurodesis.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Pacientes" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusiones" ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000003000000002/v1_201509151209/S0300289615311327/v1_201509151209/es/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/03002896/0000003000000002/v1_201509151209/S0300289615311327/v1_201509151209/es/main.pdf?idApp=UINPBA00003Z&text.app=https://www.archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289615311327?idApp=UINPBA00003Z" ]
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