胞必佳治疗老年肺癌恶性胸腔积液的疗效观察  

The clinical observation of in tracav itary perfusion with nocardia rubra cell wall akeleton in treatment of malignant pleural effusion

作　　者：何安南[1] 

机构地区：[1]安徽省芜湖市第二人民医院呼吸内科,241000

出　　处：《齐齐哈尔医学院学报》2008年第17期2058-2060,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨胸膜腔内注入胞必佳治疗恶性胸腔积液的疗效与毒副反应。方法经病理或胸水细胞学确诊为恶性胸腔积液的患者共104例,随机分为观察组(胞必佳)48例,胸腔内注入0.9%生理盐水20ml+胞必佳500μg+2%利多卡因5ml;对照组A(胞必佳+顺铂)26例,胸腔内注入0.9%生理盐水20ml+PDD80mg+胞必佳500μg+2%利多卡因5ml;对照组B(顺铂)30例,胸腔内注入0.9%生理盐水20ml+PDD80mg+2%利多卡因5ml。观察疗效、生活质量、毒副反应。结果观察组总有效率88.45%,病变进展率11.54%;较对照组A(胞必佳+顺铂)92.31%、7.69%,无显著性差异(P>0.05);较对照组B(顺铂)73.91%、26.09%,有显著性差异(P<0.05)。治疗后的毒副反应,血小板轻度降低,两组比较无差异;而白细胞降低和消化道反应,观察组(胞必佳)显著低于对照组(胞必佳+顺铂)及对照组(PDD组)(P<0.05)。结论置入静脉导管胸腔闭式引流后注射胞必佳是治疗恶性胸腔积液的有效方法,且毒性作用小。Objective To evaluate the efficacy and toxicity of pleural perfusion with nocardia rubra cell wall akeleton in the patients with malignantp leural effusion. Methods 104 patients histologically proved malignant pleural effusion were randomized into three groups：observed group（nocardia rubra cell wall akeleton）48, （ nocardia rubra cell wall akeleton 500 ug ＋0.9%NS 20ml ＋ 2% lidokarine 5ml）, group A（nocardia rubra cell wall akeleton＋PDD）26, （ nocardia rubra cell wall akeleton 500 ug＋PDD 80mg＋0. 9%NS 20ml ＋2% lidokarine 5ml）and group PDD （ PDD 80mg ＋0. 9%NS 20ml ＋ 2% lidokarine 5ml）. The patients were injected with different drugs into pleural after having been drained away the pleural effusion. The efficacy, toxicities and quality of life were evaluated. Results The response rate, progression rate was 88.45 %, 11.54 % in observed group and92.31%, 7.69 % in group A, there were none--statistical differences in two groups （P〉0.05）. And73.91% , 26.09% in group B, there were statistical differences in two groups （P 〈 0.05）. Adverse effects thrombocytopenia was mild and had no statistically significant difference in two groups （P 〉 0.05）, while the leukocytopenia and gastrointestinal disorders in observed group was much less than group A and group B （P 〈 0.05）. Conclusions Draining the fluid completely followed by intracavuty injection of nocardia rubra cell wall skeleton is effective in the treatment of MPE.

关 键 词：胞必佳 恶性胸腔积液 静脉导管 

分 类 号：R561.3[医药卫生—呼吸系统] R730.53[医药卫生—内科学]