中心静脉导管胸腔留置引流结合局部化疗对老年恶性胸腔积液的治疗作用研究

Clinical study on thoracic drainage with central venous catheter and the intrapleural administration of drugs for malignant pleural effusion in elderly patients

目的评价中心静脉导管胸腔留置引流结合局部化疗对老年恶性胸腔积液的治疗作用。方法单侧中量或大量老年恶性胸腔积液崽者65例随机分成两组，研究组33例采用中心静脉导管胸腔留置引流，对照组32例采用常规胸腔穿刺抽液，两组均胸腔局部注入顺铂、高聚生行胸膜腔封闭。结果研究组胸腔积液控制有效率为84．85％（CR11例，PR17例），明显优于对照组43．75％（CR4例，PR10例），（P〈0．01）。研究组生活质量好转率87．9％，优于对照组62．5％（P〈0．05）。结论中心静脉导管胸腔留置引流结合局部化疗对恶性胸腔积液疗效较好，且安全性高、不良反应少，适合于老年患者。

Objective To validate the efficacy of thoracic drainage with central venous catheter and the intrapleural ad- ministration of cisplatin and highly agglutinative staphylococcin for malignant pleural effusion （MPE）. Methods Sixty- five elderly patients with moderate or large amount of ipsilateral MPE were randomly divided into central venous catheter group （ test group, n = 33 ） and thoracentesis group （control group, n = 32）. Cisplatin and highly agglutinative staphylococcin （HASL） were infused into the thoracic cavity in patients after drainage. Responses were evaluated 30 days later. Results Overall response rate （complete response plus partial response） was 84.85% in test group and 43.75% in control group, respectively. There was significant difference between the two groups （P〈0.01）. The improvement rate of quality of life was markedly increased in the test group （87.9 %） as compared with the control group （62.5 %） （P〈 0.05）. Conclusion Thoracic drainage with central venous catheter and intrapleural administration of cisplatin and highly agglutinative staphy- lococcin is an efficacious treatment for elderly patients with malignant with pleural effusion.