肺癌并发恶性胸腔积液临床治疗体会

Clinical Treatment of Lung Cancer Complicated by Malignant Pleural Effusion

目的:探讨肺癌并发恶性胸腔积液的临床治疗效果。方法:本次研究选择我院2006年1月～2010年12月收治的肺癌并发忍性胸腔机液的患者140例,采用胸膜固定术进行治疗同时分析不同药物的临床效果。结果:对5组用药临床效果进行比较,其中DDP组与N-CWS组、PYM组及TNF组比较,疗效显著,差异有统计学意义(P<0.05)。本次研究胸膜固定术采用的5种药物主要以胃肠道反应、发热、胸痛为不良反应,经针对性处理后均缓解,无骨髓抑制发生,无明置心、肾、肝功能损害。其中N-CWS与其它4组发热发生率比较较高,DDP与其它4组发热发生率比较较低.差异均有统计学意义(P<0.05)。胃肠道反应、胸痛等药物副作用5组比较差异无统计学意义(P>0.05)。结论:恶性胸腔积液是肺癌患者在晚期常见的临床并发下,治疗方法应以安全有效、经济简单为前提,将药物通过闭式引流胸水后再注入胸膜腔,是目前临床用的治疗方法,临床应依据患者胸水部位、胸水引流方式、全身应用糖皮质激素情况的不同来制定治疗方案,提高患者生命质量。

Objective：To explore the lung cancer with malignant pleural effusion clinical therapeutic effect.Methods：This study selected in our hospital from 2006 January to 2010 December were lung cancer with malignant pleural effusion in 140 cases,using pleurodesis for treatment,and analysis the clinical effects of the different drugs.Results：The clinical effects were compared between 5 groups of drugs,including DDP group and N-CWS group.PYM group and TNF group,curative effect is remarkable,the difference was statistically significant（P0.05 ）.The study of pleurodesis with 5 drugs mainly gastrointestinal reactions,fever,chest pain as an adverse reaction,the targeted treatment were in remission,no bone marrow suppression occurs,no significant cardiac,renal,liver function damage. The N-CWS and other 4 groups of heating rate is higher.DDP and other 4 groups of heating rates relatively low,＇he differences were statistically significant（P0.05 ）.Gastrointestinal reactions such as chest pain medication side effects,no significant differences between the 5 groups（P0.05 ）.Conclusion：Malignant pleural effusion in patients with lung cancer in advanced stage is a common clinical and distribute,therapeutic approach should be based on safe and effective,economic and simple as the original is,the medicament through closed drainage of pleura! effusion after injected into the pleural cavity,is currently in clinical use methods of treatment,clinical should be based on the patients with hydrothorax hydrothorax drainage site,way,systemic corticosteroids applied different situations treatment plan, improve the patients＇ quality of life.