微创置管胸腔内灌注顺铂联合全身化疗治疗肺癌患者胸腔积液的临床观察

The clinical observation of thoracic cavity drainage with perfusion of cisplatin and combined systemic chem-otherapy in lung cancer with malignant pleural effusion

目的观察微创置管胸腔内灌注顺铂联合全身化疗治疗肺癌患者胸腔积液的疗效及不良反应。方法选取60例肺癌伴胸腔积液患者，应用微创置管胸腔内闭式引流，局部灌注顺铂，并同时全身化疗，非小细胞肺癌用吉西他滨联合顺铂（GP方案）化疗，小细胞肺癌以依托泊苷联合顺铂（EP方案）化疗。结果60例患者中胸腔积液完全缓解4l例，部分缓解13例，稳定4例，进展2例，完全缓解率为68．3％（41／60），总有效率为90．0％（54／60）。治疗后患者半年生存率为95．0％（57／60），1年生存率为80．0％（48／60）。局部联合全身化疗的不良反应主要是骨髓抑制和胃肠道反应。结论微创置管胸腔内灌注顺铂联合全身化疗治疗肺癌患者胸腔积液疗效明显，不良反应均可耐受。

Objective To observe the effect and adverse reactions of thoracic cavity drainage with perfusion of cisplatin and combining systemic chemotherapy in lung cancer with malignant pleural effusion. Methods Sixty cases of lung cancer with malignant pleural effusion were treated with thoracic cavity drainage with perfusion of cispl- atin and combining systemic chemotherapy. The patients with non-small cell lung cancer were treated with gemcit- abine and cisplatin. The patients with small cell lung cancer were treated with etoposide and cisplatin. Results A- mong the 60 cases,41 cases got complete remission, 13 cases got partial remission,4 cases got stable disease and 2 cases got progression disease. The complete response rate was 68.3% （41/60） and total curative rate was 90.0% （54/60）. After the treatment the half-year survival rate was 95.0% i 57/60）and the one-year survival rate was 80.0% （48/60）. The main side effects were myelo suppression and gastrointestinal reaction. Conclusions The curative effect is significant through thoracic cavity drainage with perfusion of cisplatin and combining systemic chemotherapy. The adverse effects are tolerable.