免疫、化疗、热疗三联法治疗恶性胸水疗效评估

Immunochemotherapy Combined with Hyperthermia Treatment for Malignant Pleural Effusion

目的 评估经胸腔内留置Arrow管注入高聚金葡素 (HASL)和顺铂 (CDDP)联合容式射频热疗 (三联法 )治疗恶性胸水的疗效。资料与方法 2 7例恶性胸水患者 ,胸水量均在中等以上 ,临床上有明显的胸闷、气促等症状。B超定位后 ,经皮穿刺胸腔内置入Arrow管 ,行胸水持续引流 ,注入HASL 5 0 0 0U +CDDP 6 0mg ,1次 /周。在每次胸腔内免疫、化疗后 30min内和第 3d进行胸部射频热疗 ,持续 2周为 1个疗程。完成 1个疗程后 ,评估治疗效果 ,同时观察毒副反应。结果 置管成功率 10 0 % (2 7/ 2 7) ,3例 (11.1% )发生导管周围胸水渗漏 ,2例 (7.4 % )不慎导管脱落 ,给予重新置管。 2 7例中接受 1个疗程 4例 ,2个疗程 2 0例 ,3个疗程 3例 ,平均 2 .0个疗程。总有效率 88.9%(2 4 / 2 7) ,临床症状缓解率 88.9% (2 4 / 2 7) ,2 0例治疗后KPS评分明显提高 (≥ 2 0 ) ,受益率 74 % (2 0 / 2 7)。发热是主要的毒副反应。结论 三联法治疗恶性胸水安全、有效、毒副反应轻微 。

Objective To evaluate efficacy of transpleural infusion of HASL and CDDP with preserved arrow catheter combined with capacitive radiofrequency hyperthermia in treatment for malignant pleural effusion.Materials and Methods 27 patients with middle-large volume malignant pleural effusion were carried out immunochemotherapy via transpleural perfusion HASL (5 000 U) and CDDP (60mg) after the pleural effusion was drained out with the help of ultrasound location , onetime per week,at the thirty minutes and two d...