亚砷酸胸腔灌注联合体外高频热疗对癌性胸水患者生活质量的影响  

Improvement of Quality of Life in Patients with Malignant Pleural Effusion Treated by Combined Extracorporeal High-Frequency Hyperthermia with Pleural Cavity Infusion of Arsenic Trioxide

作　　者：吴万垠[1] 周宇姝[1] 邓宏[1] 龙顺钦[1] 郑剑霄[1] 柴小姝[1] 薛晓光[1] 河文峰[1] 蔡姣芝[1] 张海波[1] 孙良生[1] 

机构地区：[1]广州中医药大学第二临床医学院肿瘤科,广东广州510370

出　　处：《上海中医药杂志》2008年第10期24-26,共3页Shanghai Journal of Traditional Chinese Medicine

基　　金：加拿大泰瑞福克斯慢跑癌症研究基金资助项目(2007002)

摘　　要：目的观察亚砷酸胸腔内灌注联合体外高频热疗对癌性胸水患者生活质量的影响。方法连续纳入45例癌性胸水病例,采用抽签法分为A、B、C组。所有患者均尽量引流胸水(至引流量小于150ml/d),A组(15例)经导管向胸腔内灌注亚砷酸20mg,拔除导管并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次;B组(16例)仅予胸腔内灌注亚砷酸20mg并拔除导管;C组(14例)于胸水引净后拔除导管,并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次。在拔管4周后复查胸水量,观察3种治疗方法对癌性胸水的疗效;治疗前后采用FLIC量表记录生活质量积分,并同时记录身体功能状况(KPS)评分变化情况。结果治疗后A、B、C组有效率分别为86.7%、62.5%和50.0%;A组胸水疗效优于B组和C组(P<0.05)。A组在躯体良好和能力、总量表领域与治疗前比较有显著性差异(P<0.05);在因癌造成的艰难领域,与治疗前比较有显著性差异(P<0.01)。3组的KPS评分均较各自治疗前提高(P<0.01),以A组的KPS评分升高最为明显。结论亚砷酸胸腔内灌注联合体外高频热疗控制癌性胸水能改善患者的生活质量,提高身体功能状况评分,对提高疗效和改善预后有一定的积极意义。To observe the influence of quality of life in patients with malignant pleural effusion treated by combination of extracorporeal high-frequency hyperthermia with pleural cavity infusion of Arsenic Trioxide. Methods Forty-five patients with malignant pleural effusion were enrolled and divided into three groups： A, B and C. After the pleural fluid had been adequately drained, group A received pleural cavity infusion of Arsenic Trioxide 20mg followed by extracorporeal high-frequency hyperthermia, once every two days for four times. In group B, all patients were treated only with pleural cavity infusion of Arsenic Trioxide 20mg. In group C, patients were only given extracorporeal high-frequency hyperthermia once every two days for four times. The efficacy of pleural effusion was investigated after four weeks. Before and after treatment, we used FLIC scale to record the score of quality of life. Meanwhile, the score of Karnofsky Performance Status was also recorded and compared. Results The overall response rate of the three groups were 86.7%, 62.5% and 50% respectively. And the efficacy of pleural effusion of group A was better than that of group B and group C（P〈0.05）. The quality of life improved evidently in group A, especially in the field of PWA （Physical well-being and ability） and GQL. Compared with pre-treatment, statistically significant difference was found （P〈 0.05）. There was a statistically significant difference in the term of HC （.Hardship due to cancer）（.P〈 0.01）. The Karnofsky score was all increased in three groups after treatment. There was a statistically significant difference between pre-treatment and post-treatment in three groups respectively（P〈0.01）. Conclusion Extracorporeal high-frequency hyperthermia combined with pleural cavity infusion of Arsenic Trioxide can improve quality of life in treating patients with malignant pleural effusion.

关 键 词：恶性胸腔积液 亚砷酸 体外高频热疗 胸腔内灌注 生活质量 

分 类 号：R730.5[医药卫生—肿瘤]