恒温体外循环热灌注治疗恶性胸腔积液的临床观察

Clinical Investigation of Hyperthermia Perfusion Extracorporeal Circulatory System in Treatment of Malignant Pleural Effusion

目的:观察恒温体外循环热灌注化疗治疗恶性胸腔积液的临床疗效。方法:于2008年1月～2011年4月选择经病理证实的肺癌或恶性间皮瘤同时伴发恶性胸腔积液的患者86倒,随机分为治疗组(n=44)和对照组(n=42)。治疗组用Astronaut体外循环热疗机热灌注化疗,对照组仅行普通控内热灌注化疗。两组化疗药物为顺铂,首次剂量90mg,以后每次60mg,1次/周,共6周。治疗前后测定胸水量,并观察生活质量改善情况及治疗副反应。结果:治疗6周后,治疗组胸腔积液CR 18例,PR20例,总有效率86.4%,对照组CR11例,PR17例,总有效率66.7%,差异有统计学上显著意义(P<0.05)。治疗组生活质量改善亦优于对照组(P<0.05)。两组患者均出现了轻微的消化道反应,可耐受。结论:体外循环热灌注顺铂治疗恶性胸腔积液,疗效显著。

Objective：To investigate clinical efficacy of hyperthermia perfusion extracorporeal circulatory system in treatment of： malignant pleural effusion.Methods：Eighty-six malignant mesothelioma and lung cancer patients with malignant pleural effusion diagnosed by pathological evidences were divided into treatment group（n=44） and control group（n=42） randomly in Jan.2008 to April 2011.The treatment group was dealt with hyppthermia perfusion extracorporeal circulatory system with DDP injection,while the cantrol group received hyperthermia perfusion and DDP intracavity injection only.The same dose of DDP were injected in two groups,firstly 90mg,and the 60mg each time,once a week,and six times in total.The volume of effusion were measured at the baseline and after treatment Life qulality and side-effects were observed in two groups too.Results：There were 18 complete response（CR） and 20 partial response（PR） in treatment group,the total effective rate was 86,4%,while 11 CR and 17 PR in control group（66.7%）.Life quality improved significantly in treatment group compared with control group,while two groups have similar slight digestive reaction.Conclusion：Hyperthermia perfusion extracorporeal circulatory system with DDP is an effective and safe way to deal with malignant pleural effusion.