胸腔内注入顺铂联合热低渗液灌注治疗恶性胸腔积液疗效观察  

Curative efficacy contrasting to treatment of malignant pleural effusion between Intrapleural cisplatine(DDP) injection and hiperthemic and hypotonic chemotherapy

作　　者：王永斌 赵晓明 

机构地区：[1]兰州市肺科医院呼吸内科,甘肃兰州730046 [2]甘肃省武山县人民医院,甘肃武山741300

出　　处：《中国当代医药》2009年第21期16-18,共3页China Modern Medicine

摘　　要：目的:探讨热低渗液胸腔内灌注并腔内化疗治疗恶性胸腔积液的临床疗效和不良反应。方法:病理确诊的恶性胸腔积液60例,经胸腔闭式引流术排尽胸腔积液后,随机分为2组,治疗组(32例)予以热低渗液胸腔内灌注后并注入顺铂(DDP)50mg/m2,对照组(28例)在胸腔内注入顺铂(DDP)50mg/m2,1周后重复1次,观察两组患者疗效、生活质量、生存率以及毒性反应。结果:治疗组总有效率为81.3%,病变进展率为3.1%,对照组总有效率为50.0%,病变进展率为25.0%,两组比较,差异有统计学意义(P<0.05),karnofsky评分大于70分者,治疗组与对照组比较,差异有统计学意义,P<0.05。治疗组0.5、1.0、1.5及2.0年的生存率分别为96.9%、59.4%、43.8%、6.3%,分别高于对照组的71.4%、50.0%、14.3%、3.6%,其中0.5年,1.5年的生存率比较,差异有统计学意义,P<0.05,两组红细胞、白细胞、血小板下降及消化道反应两者比较,差异无统计学意义。结论:热低渗液胸腔内灌注并化疗治疗恶性胸腔积液临床疗效优于单纯胸腔内化疗,疗效持久,无严重不良反应。Objective：To investigate clinic curative efficacy and adverse drug reaction （ADR） on intrapleural hiperthemic and hypotonic chemotherapy to malignant pleural effusion malignant pleural effusion.Methods：After 60 cases with malignant pleural effusion were completely drained out pleural effusion by closed drainage tubes and then randomly divided into two groups,intrapleural hiperthemic and hypotonic chemotherapy and DDP 50 mg/m^2 were successively injected into pleural cavity of 32-case therapy group（T）, and only DDP 50 mg/m^2 into 28-case control group（C）. With repeated trial one week later, the efficacy, quality of life （QOL）, survival rate, and toxicity were evaluated. Results：The overall response rate and improved lesion rate were respectively 81.3% and 3.1% in T group, 50.0% and 25.0% in control group with significant difference between two groups （P〈0.05）. Karnofsky score was greater than 70,which indicated that T group had improved more remarkably than control group. The half-yearly, one-yearly, one and half-yearly, and two-yearly survival rates were 96.9%, 59.4%, 43.8%, 6.3% respectively in T group,which were higher than 71.4%, 50.0%, 14.3%, 3.6% in C group accordingly,and among which half-yearly and one and half-yearly survival rates had significant difference.Erythropenia, leucopenia, thrumbopenia and peptic tract reaction had no cignificant difference in two groups. Conclusion：Intrapleural hiperthemic and hypotonic chemotherapy has more advantageous healing efficacy than simple intrapleural perfusion due to its effective and permanent curative effect on malignant pleural effusion without severe ADR.

关 键 词：热低渗液 胸腔内灌注 化疗 恶性胸腔积液 

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