胸膜腔置管引流并灌注复方苦参注射液联合顺铂治疗肺癌恶性胸腔积液的疗效和护理

Curative effect and nursing of thoracic cavity drainage and compound kushen injection combined with cisplatin in the treatment of lung cancer patients companying with malignant pleural effusion

目的探讨胸膜腔置管引流并灌注复方苦参注射液联合顺铂治疗肺癌恶性胸腔积液的近期疗效、副反应及护理。方法 88例肺癌伴恶性胸腔积液患者,先以中心静脉导管行胸膜腔置管和引流胸水,其后给予胸膜腔内注药及全程护理。治疗组46例以复方苦参注射液20 m L/次联合顺铂40~60 mg/次胸膜腔内灌注。对照组42例单用顺铂40~60 mg/次胸膜腔内灌注,每7 d注射1次,连续注射3次。观察2组1月后的治疗效果、生活质量评分（KPS）及并发症。结果治疗组有效率优于对照组（P〈0.05）。治疗组治疗后KPS评分提高改善率高于对照组,2组比较差异有统计学意义（P〈0.05）。2组的并发症差异无统计学意义（P〉0.05）。结论胸膜腔置管引流并灌注复方苦参注射液联合顺铂治疗肺癌恶性胸腔积液疗效肯定,全程规范细致的护理是治疗成功的关键因素。

Objective To explore the short- term effect,adverse reactions and nursing thoracic cavity drainage and compound kushen injection combined with cisplatin in the treatment of lung cancer patients companying with malignant pleural effusion. Methods A total of 88 lung cancer patients with malignant pleural effusion were applied the central venous catheters and were taken the thoracic drainage. Afterwards,the patients were given pleural cavity injection and whole course nursing. The patients in treatment group（ n = 46） were treated by intracavity injection of compound kushen injection with 20 m L every time and cisplatin with 40 ~ 60 mg every time,and those in control group（ n = 42） were treated by intracavity injection of cisplatin with 40 ~ 60 mg every time. The above doses were given one time every 7 days for 3 weeks. The therapeutic effect and life quality score（ KPS） and complications were observed after one month. Results The effective rate in the treatment group was higher than that in the control group（ P〈0. 05）. The improvement rate of KPS score in the treatment group was better than that in the control group,the difference was statistically significant（ P〈0. 05）. The complication of the two groups showed no significant difference（ P〉0. 05）.Conclusion Thoracic cavity drainage and compound kushen injection combined with cisplatin is more effective for the treatment of malignant pleural effusion. The standard and careful nursing is the key factor for successful treatment.