沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液81例疗效分析

Therapy effect of 5-FU palliative implanted through puncturing along cardiac tangent direction in 81 patients with malignant pericardial effusion

目的探讨沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液技术的临床应用价值。方法在超声引导下对81例恶性心包积液患者沿心脏切线方向进行心包穿刺并植入5-FU缓释粒子,治疗后每周行超声检查,4周后评价疗效,以同期心包置管引流并腔内化疗的45例患者作为对照。结果 81例均一次性穿刺成功。缓释化疗粒子植入治疗后第4周超声复查,71例完全缓解,8例部分缓解,2例无效。总有效率达97.53%,高于置管引流组(77.78%),差异有统计学意义(P<0.01)。结论沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液操作安全,疗效好,不良反应少,是目前较为理想的治疗方案。

Objective To investigate the clinical value of the 5-FU sustained-release particles implanted through punctu- ring along the cardiac tangent direction for malignant pericardial effusion. Methods 81 patients with malignant pericar- dial effusion were treated by pericardiocentesis guided by ultrasound and 5-FU palliative particles were implanted into the pericardial cavity. The puncturing path was along the cardiac tangent direction. Ultrasound examinations were used ev- ery week after the treatment. The efficacy was evaluated four weeks after the treatment. The 45 patients treated by peri- cardial catheter drainage and intracavitary chemotherapy at the same period were served as controls. Results The punc- turing success rate was 100% in the 81 cases. Ultrasound reviews showed that complete remission occurred in 71 ,partial remission in 8, and no response in 2 cases four weeks after the treatment. The total remission rate was 97.53%, which Was significantly higher than that in the control group （77.78 %, P 〈 0.01 ）. Conclusion It is a new ideal method to treat malignant pericardial effusion to implant 5-FU sustained-release particles through puncturing along the cardiac tan- gent direction for its high safety and efficacy and less adverse reactions.