循环热低渗化疗治疗恶性胸腔积液的临床研究  

Clinical investigation of cyclic intrapleural hyperthermic and hypotonic chemotherapy on malignant pleural effusion

作　　者：查日田[1] 丁红梅[1] 王谨[1] 周超[1] 林琳[1] 胡斌[1] 舒守宏[1] 吴昊[1] 方平[1] 

机构地区：[1]铜陵市人民医院呼吸内科,安徽铜陵244000

出　　处：《中国呼吸与危重监护杂志》2006年第5期362-365,共4页Chinese Journal of Respiratory and Critical Care Medicine

基　　金：安徽省卫生厅第五批科学研究基金立项资助(2002B016)

摘　　要：目的探讨循环热低渗化疗治疗恶性胸腔积液的临床疗效和不良反应。方法将18例恶性胸腔积液病人随机分为两组,治疗组7例,对照组11例。经胸腔闭式引流术排尽胸腔积液后,两组均行40mg/m2的顺铂胸腔内灌注化疗,治疗组予以循环热低渗化疗,对照组予以单次性注射化疗,必要时1个月内重复治疗。比较两组病人的呼吸困难状况、Karnofsky评分、胸腔积液吸收情况及不良反应。结果治疗组均治疗了1次,对照组11例中有6例进行了2次治疗。治疗组病人呼吸困难状况和Karnofsky评分均显著好于对照组。胸腔内化疗后1个月,治疗组胸腔积液的治疗有效率85.71%,对照组66.64%,两组比较无显著性差异(P>0.05);胸腔内化疗后2个月,治疗组胸腔积液的治疗有效率保持在85.71%,对照组下降至12.50%,两组比较有显著性差异(P<0.05)。对照组和治疗组病人均出现较明显的恶心和呕吐反应。结论循环热低渗化疗治疗恶性胸腔积液的临床疗效优于单次性胸腔内化疗,疗效持久,无严重不良反应。Objective To investigate the curative effect and auxihary reaction of cyclic intrapleural hyperthermic and hypotonic chemotherapy on malignant pleural effusion. Methods 18 cases with malignant pleural effusion were randomly divided into two groups. After a complete drainage of pleural effusion through a closed drainage tube, 7 cases were treated with cyclic intrapleural hyperthermic and hypotonic chemotherapy as treatment group and 11 cases were intrapleural perfused with chemotherapeutics by one single injection as controls. All cases were intrapleural peffused with cisplatine dosed as 40 mg/m^2 and gave a second dose if needed. Dyspnea, Kamofsky scores, curative rate and side effects were assessed. Results All cases received one dosage in the treatment group but six cases in the control group received two dosages. The degree of dyspnea was lower and Kamofsky scores were higher significantly in the treatment group than those in the control group. One months later aft＆ treatment, the effectiveness rate for malignant pleural effusion was 85.71% in the treatment group and 66.64% in the control group with no significant difference （P 〉 0.05）. However, the effectiveness rate remained 85.71% in the treatment group but dechned to 12.50% in the control group two months after treatment with significant difference （ P 〈 0.05 ）. Conclusion Compared with single intrapleural injection, cyclic intrapleural hyperthermic and hypotonic chemotherapy is more effective and permanent to treat mahgnant pleural effusion with milder side effects.

关 键 词：热低渗化疗 恶性胸腔积液 闭式引流 

分 类 号：R730.5[医药卫生—肿瘤]