两种方法治疗肺癌胸水的疗效评价

Appraisal of Two Different Curative Modalities in Lung Cancer With Pleural Effusion

１９８９年１０月至１９９６年１０月采用胸腔插管闭式引流胸水后注药及胸穿抽水后注药两种不同方法治疗肺癌胸水９６例，胸腔内分别注入顺铂、阿霉素、丝裂霉素三种不同药物，其目的是为了比较两种不同方法、三种不同药物治疗肺癌胸水的疗效。结果显示引流组各种药物胸腔内注射疗效均较胸穿抽液组好，引流组总有效率８３．９％（４７／５６）较胸穿抽液组５７．５％（２３／４０）有显著差异（Ｐ＜０．００５）；顺铂引流组有效率９２％（２３／２５）较顺铂胸穿抽液组有效率６０％（１２／２０）有显著差异（Ｐ＜０．０５）；同组中三种药对比无显著差异。研究分析提示，胸腔引流注药治疗肺癌胸水是值得推广应用的好方法。顺铂是治疗肺癌胸水较理想的化学药物。

Ninety six patients with lung cancer having pleural effusion were treated by the two different methods pleural cavity sealing drainage with local instillation of drugs and pleurocentesis with local instillation of drugs, from October 1989 to October 1996. The drugs instilled into the pleural cavity were DDP. adriamycin and mitomycin. The purpose was to compare curative effect about two kinds of curative modalities and three different drugs in patients of lung cancer with pleural effusion.Results indicated that tube drainage with local injection of drugs was more effective than pleurocentesis with local therupy.The effective rates of thedrainage group and the pleurocentesis group were 83.9%(47/56)and 57.5%( 23/40) respectively. There were significant statistical differences between the two groups(P<0.005).The effective rates of the tube drainage with local injection of DDP and the pleurocentesis with local injection of DDP were 92%(23/25) and 60%(12/20)respectively. The statistical analysis showed that the two groups had significant difference(P<0.05).The curative effects of significant difference were not found among three different drugs either in the drainage or in pleurocentesis group. The result suggested that the method of tube drainage with local injection of drugs is better than that of pleurocentesis with local injection of drugs.DDP is more ideal anticarcinogen for lung cancer with pleural effusion, and so are adriamycin and mitomycin.