微导管联合重组人P53腺病毒治疗恶性胸腔积液临床观察

Clinical observation of microcatheter combined with recombinant human P53 adenovirus （ rAd- P53） in treating malignant pleural effusion

目的观察微导管持续引流联合重组人P53腺病毒（rAd—P53）治疗恶性胸腔积液的临床疗效。方法将41例恶性胸腔积液患者随机分为治疗组和对照组，治疗组行穿刺微导管置入引流胸水后，胸腔内注射rAd—P53，在rAd，P53注射后72h胸腔内再注入顺铂40mg，每周1次，用2～4次；对照组除不用rAd—P53外，胸腔内化疗同治疗组。结果治疗组与对照组有效率分别为83．3％、56．5％，治疗组不良反应主要为自限性发热，12—24h后可自行恢复正常。结论微导管联合rAd—P53及顺铂治疗恶性胸腔积液疗效好、安全，值得临床推广应用，

Objective To observe the clinical effect of microcatheter continued drainage combined with recombinant human P53 adenovirus （rAd-P53） on malignant pleura1 effusion. Methods Forty-one patients with malignant pleural effusion were randomly divided into treatment group and control group, the patients in treatment group were injected with rAd-P53 into the chest after pleural effusion drainage by mi- croeatheter, then were injected with cisplatin 40 mg into the chest after 72 hours, once a week, treated for 2 -4 times; The patients in control group were treated with the same chemotherapy as the treatment group without injecting rAd-P53 into the chest cavity. Results The effective rates of treatment group and control group were 83.3% and 56. 5%, respectively. The major adverse reaction of treatment group was self-limit- ed fever, the temperature could return to normal in 12 -24 hours. Conclusions The treatment of malig- nant pleural effusion by microcatheter continued drainage combined with recombinant human P53 adenovi- ms, and cisplatin is effective and safe, which should be applicated in clinics.