The Value Of Spraying Erythromycin Under Thoracoscopy In The Treatment Of Recurrent Pneumothorax

ObjectiveTo evaluate the clinical effect of erythromycin pleurodesis under thoracoscopy in the treatment of recurrent pneumothorax.Method1.General condition of the patients:58 cases of recurrent pneumothorax patients were selected in Shandong provincial hospital from 2001.01-2008.12,28 in erythromycin group and 30 randomly selected in talc group.There are no significant difference of the clinical features between the two groups, such as age, gender, duration of symptoms.(Table 1)Table 1 Basic clinical characteristics of two groups 2.Clinical treatment:All the patients of two groups were operated pleurodesis under thoracoscopy by spraying pleural adhesions agent.Erythromycin group:For the 28 patients,1-1.5 g erythromycin were sprayed into the pleural cavity by powder spraying device under thoracoscopy.The control group (talc group):For the 30 patients,3-5g medical talc were sprayed into the pleural cavity by powder spraying device under thoracoscopy.All drugs were sprayed evenly distributed in the pleural surface, and after the operation a draft tube was placed.Results1.Effective rate:the effective rate of erythromycin group was 75%, while talc group was 96.7%,there was no significant difference.(P>0.05)2.The mean time of pulling out thoracic duct of erythromycin group was 106.2±38.5h,while talc group was 84.0±26.2h,there was significant difference. (P<0.05).3.Adverse reactions:fever of erythromycin group was 71.3% while talc group was 31%,there was significant difference(.P<0.05).The chest pain of erythromycin group was 61.9%,42.9% of patients were so pain that need to give analgesics;while talc group was 55.2%,37.9% of patients were so pain that need to give analgesics;there was no significant difference.(P<0.05)4.Recurrence rate Recurrence rate of erythromycin group was 19.0% while talc group was 3.5%,there was no significant difference.(P<0.05)Conclusions1.The pleurodesis used erythromycin under thoracoscopy is a kind of effective method to cure recurrent pneumothorax.2.Compared with talc powder, the pleurodesis used erythromycin under thoracoscopy has lower efficiency, higher rate of adverse reactions,so it is difficult for erythromycin to widely use as adhesion agent.