心包腔内置管引流并注药治疗恶性心包积液的临床观察  

Clinical Observision of Intrapericardial Drug through Intraducing the Intrapericardial Indwelling Tube in Patients with Malignant Pericardial Effusion

作　　者：阮新建[1] 刘畅[1] 

机构地区：[1]北京军区总医院肿瘤科,北京100007

出　　处：《中国药物警戒》2011年第11期648-650,共3页Chinese Journal of Pharmacovigilance

摘　　要：目的观察超声引导下心包腔内留置中心静脉导管并腔内给药治疗恶性心包积液的近期疗效及安全性。方法 46例恶性心包积液患者在B超引导下经皮穿刺心包腔内置入中心静脉导管,将心包积液引流干净,先用生理盐水100mL经导管冲洗心包腔,然后注入生理盐水20mL+顺铂40mg+白细胞介素-2200万IU+地塞米松5mg,若引流液<30mL/24h,经B超证实心包积液引流干净,则可拔管。治疗期间适当给与水化补液及止吐等处理。结果 46例均一次置管成功,疗效评价:CR15例、PR24例、NC6例、PD1例,RR84.78%;治疗后KPS评分提高了10～40分。毒副反应主要为Ⅰ～Ⅱ度的胃肠道反应、骨髓抑制和低热,无心包穿刺置管相关死亡。结论超声引导下留置静脉导管并腔内给药是治疗恶性心包积液安全、有效、方便的治疗方法。Objective To evaluate the clinical efficacy and side effects of intrapericardial drug in the patients with malignant pericardial effusion. Methods 46 patients with malignant pericardial effusion were treated by intraducing the intra pericardial indwelling tube and drawing out the pericardial effusion and then washing the pericardial cavity with 100ml physiological saline and instillation of 20mL physiological saline, cisplatine 40mg, interleukin-2 200 MIU and dexamethasone 5mg. The tube was removed when the pericardial fluid was less than 30mL and proved by type B ultrasonic. Hydration and antiemesis should be processed during treatment. Results 15 patients achieeved complete response, 24 achieved partial response,6 patients achieved no change and 1 patients achived progressive disease. The overal response rate was 84.78 percent. The KPS score elevated 10 to 40.The main side effects were Ⅰ～Ⅱ grade gastroin- testinal reaction, bone marrow depression and fever. No patient died of intraducing the intra pericardial indwelling tube. Conclusion Intrapericardial drug through intraducing indwelling tube maybe a safe, effective and convenient way to control the malignant pericardial sffusion.

关 键 词：超声引导 心包置管 心包积液 

分 类 号：R730.58[医药卫生—肿瘤]