肺癌伴恶性胸水的手术与免疫治疗  

Surgery and Immunotherapy for Lung Cancer with Malignant Pleural Effusion

作　　者：李国庆[1] 单根法[1] 朱恩良[1] 张辅贤[1] 钟 

机构地区：[1]上海第二医科大学附属新华医院成人心胸外科

出　　处：《中华胸心血管外科杂志》1998年第3期161-163,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：为了达到既切除原发病灶又控制胸膜病变和消除胸水的目的，对９例肺癌伴恶性胸水者行手术加免疫治疗，其中７例作肺叶切除，２例作全肺切除。术后胸内灌注ｒＩＬ２，ｒＴＮＦ。结果所有病人胸水消失，症状缓解期＞６个月。除３例术后７、８、２１个月仍生存外，其余死于术后８～１８个月（平均１３．３３±３．２４个月）。结论：手术切除原发病灶减轻了肿瘤负荷，消除了肺部感染、出血病灶；部分肿瘤只累及脏层胸膜者获相对根治效果；减少或推迟了远处转移的可能性；切除原发病灶后用ｒＩＬ２、ｒＴＮＦ能更有效消除胸水，控制胸膜病变；Aim:To evaluate the effects of surgery and postoperative immunotherapy for lung cancer with malignant pleural effusion.Clinical material and method:Nine patients with lung cancer associated with malignant pleural effusion were treated by surgical resection and postoperative immunotherapy.Surgical procedures performed included lobectomy in 7 and pneumonectomy in 2.All patients received postoperative intrapleural infusion of γIL 2 and γTNF daily for three days.After each infusion,the drainage tube was clamped for 12 hours and then opened again.The mean duration of chest drain was 8.56±2.46 days(range,5 to 12 days).The mean volume of chest drainage was 2655±1240ml(range,1200 to 4700 ml).Results:There were no operative deaths.The malignant pleural effusion was completely controlled after surgery and immunotherapy.Patients' general condition were significantly improved.The mean survival time was 13.3± 3.2 months.Three patients still alive at 7,8 and 21 months,respectively.Conclusion:Surgery plus postoperative immunotherapy can improve patients' quality of life and enhance survival time.

关 键 词：肺肿瘤 恶性胸水 外科手术 免疫疗法 

分 类 号：R734.205[医药卫生—肿瘤]