恶性肿瘤并发腹腔积液的特点及治疗措施的探讨

Study of Characteristics of Malignant Tumor Complicated with Ascites and Therapeutic Measures

目的探讨恶性肿瘤并发腹腔积液的特点以及治疗措施。方法选择各种恶性肿瘤并发腹腔积液患者156例,同期经腹腔积液检查为良性腹腔积液的60例患者作为对照,通过比较分析恶性肿瘤并发腹腔积液的特点。结果恶性腹腔积液患者出现浮肿、发热症状的可能性较低,出现移动性浊音体征的可能性高,与良性腹腔积液患者存在显著差异(P<0.05);恶性腹腔积液组和结核性腹腔积液组LDH水平明显高于肝硬化腹腔积液组,恶性腹腔积液组和肝硬化腹腔积液组ADA水平明显低于结核性腹腔积液组(P<0.05);恶性腹腔积液组CEA、AFP、CA199水平显著高于结核性腹腔积液组和肝硬化腹腔积液组(P<0.05)。156例恶性腹腔积液患者治疗后CR 3例,PR 50例,有效率为34.0%;不良反应主要为消化道症状、白细胞和血小板下降。结论恶性肿瘤并发腹腔积液患者较少出现浮肿、发热症状,ADA水平偏低,CEA、AFP、CA199水平偏高,采用中医药联合灌注化疗有利于提高疗效,减轻不良反应。

Objective To investigate characteristics of malignant tumor complicated with ascites and therapeutic meas -ures .Methods 156 cases of malignant tumor complicated with ascites and 60 cases of benign ascites patients were selected .The characteristics of malignant tumor complicated with ascites were analyzed .Results Malignant tumor complicated with ascites had low possibility of edema and fever ,and high possibility of shifting dullness ,there were significant differences compared with benign ascites (P<0.05);LDH level in the malignant and the tuberculous groups were higher than that of the cirrhotic group ,ADA level in the malignant group and the cirrhotic group were lower than that of the tuberculous group (P<0.05);CEA、AFP and CA199 level in the malignant group were higher than those of the tuberculous group and the cirrhotic group (P<0.05);there were 3 ca-ses of CR(complete response),50 cases of PR (partial response)in 156 cases of malignant tumor complicated with ascites ,the ef-fective rate was 34.0%;gastrointestinal symptoms ,leukopenia and thrombocytopenia were the main adverse reactions .Conclusion In malignant tumor complicated with ascites ,there are less swelling and fever ,ADA level is low while CEA、AFP、CA199 level is high,traditional Chinese medicine combined with infusion chemotherapy can improve efficacy and reduce adverse reactions .