恒温循环热灌注化疗治疗恶性胸腔积液临床研究

Treatment of malignant pleural effusion using constant temperature and circulatory hyperthermia perfusion

目的观察恒温循环热灌注化疗对恶性胸腔积液的治疗效果、治疗后患者生活质量的改善及其不良反应。方法将我科确诊恶性胸腔积液患者180例,随机分为治疗组(90例)和对照组(90例),治疗组行胸腔恒温循环热灌注化疗,对照组仅行胸腔热灌注化疗。两组均胸腔内注入顺铂(DDP),首剂90 mg,后每次60 mg,每周1次,共6次。结果治疗组控制胸水有效率(CR+PR)为94.4%,对照组为64.4%,两组间比较差异有统计学意义(P<0.01)。治疗组与对照组生活质量好转率分别为85.56%和62.22%(P<0.01)。不良反应方面,消化道反应与血液学毒性,两组间差异均无统计学意义(P=1.000)。结论采用胸腔恒温循环热灌注化疗方法治疗恶性胸腔积液疗效确切,安全性高,值得在临床广泛推广。

Objective To study the efficacy, effect on life quality and toxicities of eonstant temperature and circulatory hyperthermia perfusion in treatment of malignant pleural effusion. Methods 180 patients with malignant pleural effusion were randomly divided into the study group（ n = 90 ） and the control group（ n =90）. The study group was treated with constant temperature and circulatory hyperthermia perfusion combined with drug （DDP） injection. The control group was treated with hyperthermia perfusion combined with intraeavitary chemotherapy. The same dose of DDP was injected into the thoracic cavity,90 mg at first and then 60 mg each time, once a week,and six times in total. Results The total effective rate for pleural effusion was 94.4% in the study group and 64.4% in the contrnl group. There was significant statistieal difference between the two groups （ P 〈 0.01 ）. The life quality in the study group （85.56%） was significantly improved compared with the control group （62.22%） （ P 〈0. 01 ）. Toxieities of digestive reaction and myelvsuppression showed no significant difference （ P = 1. 000）. Conclusions Constant temperature and circulatory hyperthermia perfusion is an effective and safe therapy for malignant pleural efft, sion, which should be widely applied in clinicat treatment.