长期心包置管治疗对肺癌心包转移的影响

The impact of long-term catheter implanted in pericardium on the outcome of lung cancer patients with pericardial transmission

目的 探讨长期心包内置管治疗肺癌伴心包转移的近期疗效和对患者生存时间的影响以及安全性。方法将入选106例患者随机分为A、B两组。A组53例为长期置管组，置管时间为8周；B组53例为短期置管组，置管时间〈4周。两组患者均接受相同的治疗方案，分别观察近期疗效、半数生存时间、两个月内的复发率及置管并发症。结果A，B两组近期完全缓解率（53．33％VS37．5％，X^2=4．17，P〈0．05）和总有效率（91．67％VS76．59％，X^2=3．87，P〈0．05），均有统计学意义。拔管后两个月内的复发率A、B两组分别为20．83％和39．58％（r=4．00，P〈0．05），1年内的存活率分别为43．75％和20．83％（r=5．76，P〈0．05），两者比较均有显著性差异。半数生存期两组分别为8个月和4个月。A，B两组生存率分析有统计学意义（P〈0．05）。两组患者均未发现化脓感染、窦道形成、心包感染及严重粘连等并发症。结论长期心包置管治疗疗效可靠，安全性高，尤其对心包内有癌细胞种植的患者，可明显延长其生存时间。

Objective The present study was undertaken to investigate the effects of long term extraction from pericardium on the life of the patients, and to evaluate the early effects and safety of long-term implanted catheter in pericardium on them with lung cancer and pericardial transmission. Methods 96 cases enrolled were randomly devided into two groups（ group A and group B ）, the period of implanted catheter was eight weeks in group A and less than four weeks in group B. The treatment protocal of the two groups was the same, then to observe the outcome, survival time of patients the recurrence rate of pericardial effusion, the complications relevant to the catheter. Results The early complete relief rate （CRR）of two groups （A, B ）was of statistic significance（53.33% vs 37. 5% ,X^2 =4. 17, P 〈 0.05 ）, the total effective rate of two groups had the statistic differences（91.67%vs 77.08% ,X^2 = 3.87, P 〈 0. 05 ）. The recurrence rate of two groups within two months was 20. 83% and 39.58% （X^2 = 4. 00, P 〈 0. 05 ） , the survival rate of group A and group B within one year was 43.75% and 20. 83% （X^2 =5.76 ,P 〈0. 05）. The median period of two groups was 8 months and 4 months. The survival rate of two group was of statistic significance（ P 〈 0.05 ）within one year. There were not pyogenic infection,fistula formation,penicarditis severe pericardiosymphysis and myocardial injury between two groups. Conclusion The long-term implanted catheter treatment is an effective and safe way to lung cancer patients with pericardial transmission, which may prolong the survival time of them.