胸腔镜下胸腔热灌注治疗肺癌性胸水的临床观察

Clinic observation on treatment of pleural effusion caused by lung carcinoma with circular intrapleural hyperthermic perfusion under video-assisted thoracoscopy(VATS)

目的:观察胸腔镜下胸腔热灌注治疗肺癌性胸水的近期疗效。方法:8例肺癌性胸水患者在胸腔镜活时接受胸腔灌注温热蒸馏水1次,时间60分钟,热灌注结束后胸腔内均匀散入顺铂60mg,术后1周始行"GP"或"NP"方案化疗4-6周期。结果:8例患者胸水控制总有效率达100%,灌注后胸闷、胸痛症状明显改善,但有大汗、潮热、体温升高、心率增快等不适,经对症处理后消失,Karnofsky评分提高10分以上,随访2月至1年,无1例胸水复发。结论:胸腔镜下胸腔热灌注治疗肺癌性胸水有效率高、不良反应小、操作简便、近期疗效佳,值得临床推广应用。

Objective：To obsevate the immediate treatment effectiveness of pleural effusion（PE） caused by lung carcinoma with circular intrapleural hyperthermic perfusion under video - assisted thoracoscopy （ VATS ）. Methods： Eight patients with pleural effusion（PE） caused by lung carcinoma were received one time circular intrapleural hyperthermic perfusion when they were pleural biopsy under VATS,time 60 minutes. Subsequently, uniformity intrapleural injected of 60mg cisplatin. They were executed 4 -6 cycles chemotherapy with gemcitabine ＋ cisplatin （GP） or navelbine ＋ cisplatin （NP） after operation one week. Results： Eight patients with pleural effusion（ PE ） caused by lung carcinoma achieved total response rate of 100% （8/8）. The chest choking and chest painful symptom were obvious improvement after intrapleural hyperthermic perfusion, but had the big sweat, tide hot, the body temperature gone up, the heart rate increased quick etc. not well, after handled to the symptom disappeared, the grade point of Karnofsky increased 10 cent above,with visiting from two months to one year, had no 1 case chest water relapsed. Conclusion： The treatment of pleural effusion caused by lung carcinoma with circular intrapleural hyperthermic perfusion showed effective, safety, convenient and good immediate treatment effectiveness under VATS, it deserved the clinical expansion the application.