射频热疗联合胸腔内注射药物治疗老年人恶性胸腔积液的临床研究

Clinical study of hyperthermia combined with intrathoracic drug injection to treat elderly patients with malignant pleurai effusion

目的观察胸腔深部射频热疗联合胸腔内注射榄香烯加顺铂治疗老年人恶性胸腔积液的疗效和不良反应。方法确诊为肿瘤所致的恶性胸腔积液的老年患者75例，≥60岁，随机分为两组。采用中心静脉置管进行胸腔引流术尽可能排爆胸水，A组38例，平均年龄（70．3±2.4）岁，患者给予胸腔内注射榄香烯300mg联合顺铂30mg，每周1次。然后进行患侧胸腔深部射频热疗；B组37例，平均年龄（69．5±2．6）岁患者只给予胸腔内注射榄香烯300mg联合顺铂30mg，每周1次。结果两组总有效率，即完全缓解率＋部分缓解率为：A组86．84％，B组62．16％，两组差异有统计学意义（P〈0.05），A组与B组生活质量好转率分别为81.58％和62．16％（P〈0.05）。结论胸腔深部射频热疗联合榄香烯加顺铂治疗老年恶性胸水有较好效果，毒副作用小，是安全有效的方法。

Objective To observe the curative effects and adverse reactions of intrapleural hyperthermia combined with intrathoracic elemene injection and cisplatin in elderly patients with malignant pleural effusion. Methods 75 elderly patients （age 〉 60 years） with malignant pleural effusion caused by cancer were randomly divided into two groups： group A （n = 38） and group B （n=37）. Patients in group A were given intrathoracic elemene injection （300 mg） combined with cisplatin （30mg） and then underwent toipsilateral intrapleural hyperthermia, while patients in group B were given only intrathoracic elemene injection （300mg） combined with cisplatin （30mg）. Results The total effective （CR＋PR） rates of group A and group B （86.84 % v 62.16 %） were significant difference （P〈0.05）, meanwhile the quality of life improved were 79.49 % （group A） and 51.28 % （group B） （P〈0.05）. Conclusions Intrapleural hyperthermia combined with intrathoracic elemene injection combined with cisplatin in the treatment of elderly patients with malignant pleural effusion has a therapeutic effect and seldom adverse effect, and it also can improve the life quality of patients, thus, it is safe and effective treatment.