双腔中心静脉导管胸腔穿刺引流并羟基喜树碱联合IL-2序贯注射治疗恶性胸腔积液的临床效果观察  

Clinical Effect Observation on Malignant Pleural Effusion Treated by Pleural Puncture Drainage with Double Lumen Central Venous Catheter and Sequential Injection of Hydroxycamptothecin Combined with IL-2

作　　者：邢海莉 王丽稳 乔三福 XING Haili;WANG Liwen;QIAO Sanfu(Chengde County Hospital,Chengde 067400,China;不详)

机构地区：[1]承德县医院,河北承德067400

出　　处：《中外医学研究》2022年第35期9-13,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：承德市科技计划项目(202203A003)。

摘　　要：目的:探讨双腔中心静脉导管胸腔穿刺引流合并羟基喜树碱(HCPT)与白介素-2(IL-2)序贯注射治疗恶性胸腔积液的临床效果。方法:选取2021年3月-2022年3月承德县医院接收的90例恶性胸腔积液患者,按随机数字表法分两组,各45例。在双腔中心静脉导管胸腔穿刺引流基础上,对照组予以IL-2序贯注射联合顺铂治疗,观察组在对照组基础上予以HCPT治疗,对比两组的凋亡调控因子、血清肿瘤标志物、总有效率、肺功能与生存质量情况。结果:治疗后,观察组的胸水中Bcl-2、Survivin水平低于对照组,Bax水平高于对照组(P<0.05);治疗后,观察组的血清甲胎蛋白(AFP)、癌胚抗原(CEA)水平低于对照组(P<0.05);观察组的总有效率为91.11%,高于对照组的73.33%(P<0.05);治疗后,观察组的每分钟最大通气量(MVV)、第1秒用力呼气容积/用力肺活量(FEV_(1)/FVC%)水平、卡氏功能状态评分(KPS)均高于对照组(P<0.05)。结论:双腔中心静脉导管胸腔穿刺引流合并HCPT与IL-2序贯注射治疗恶性胸腔积液可有效改善凋亡调控因子、血清肿瘤标志物水平,进一步提升临床疗效,并提高患者肺功能与生存质量。Objective:To investigate the clinical efficacy of double lumen central venous catheter combined with sequential injection of Hydroxycamptothecin(HCPT)and interleukin-2(IL-2)in the treatment of malignant pleural effusion.Method:A total of 90 patients with malignant pleural effusion were received in Chengde County Hospital from March 2021 to March 2022 were selected,and divide into two groups according to the method of numerical random table,45 cases in each group.On the basis of thoracic puncture and drainage with double lumen central venous catheter,the control group was treated with IL-2 sequential injection combined with Cisplatin,and the observation group was treated with HCPT on the basis of the control group.The apoptosis regulatory factors,serum tumor markers,total effective rate,lung function and quality of life were compared between the two groups.Result:After treatment,the levels of Bcl-2 and Survivin in pleural fluid in the observation group were lower than those in the control group,and the levels of Bax was higher than that in the control group(P<0.05).After treatment,the levels of serum alpha fetoprotein(AFP)and carcinoembryonic antigen(CEA)in the observation group were lower than those in the control group(P<0.05).The total effective rate in the observation group was 91.11%,which was higher than 73.33%in the control group(P<0.05).After treatment,the maximum ventilation volume per minute(MVV),forced expiratory volume in one second/forced vital capacity(FEV_(1)/FVC%)and Karnaugh functional status score(KPS)in the observation group were higher than those in the control group(P<0.05).Conclusion:Thoracocentesis and drainage with double lumen central venous catheter combined with sequential injection of HCPT and IL-2 in the treatment of malignant pleural effusion can effectively improve the levels of apoptosis regulating factors and serum tumor markers,further enhance the clinical efficacy,as well as improve the pulmonary function and quality of life of patients.

关 键 词：双腔中心静脉导管 胸腔穿刺引流 羟基喜树碱 白介素-2 恶性胸腔积液 

分 类 号：R730[医药卫生—肿瘤]