循环胸腔热灌注化疗治疗恶性胸腔积液的临床研究

The Clinical Study of Continuous Intrapleural Hyperthermochemotherapy Perfusion in the Treatment of Malignant Pleural Effusion

目的探讨循环胸腔热灌注化疗治疗恶性胸腔积液的临床疗效。方法选取我院收治确诊的恶性胸腔积液患者60例,并随机分为观察组和对照组。观察组30例,给予灭菌蒸馏水2 000 ml+顺铂(cis-diaminodichloroplatinum,CDDP)200 mg/m2胸内热疗60 min;对照组30例,则单纯胸内注入无菌滑石粉浆5 g。结果临床疗效观察显示,观察组有效率为83.3%(25/30);对照组有效率为43.3%(13/30);两组间临床疗效的差异有统计学意义(χ2=10.335,P=0.001)。Karnofsky生活质量评分显示,观察组总提高率为73.3%(22/30),对照组总提高率为46.7%(14/30),两组间总提高率差异有统计学意义(χ2=4.444,P=0.035)。两组患者围手术期均未出现严重并发症,观察组术后出现不良反应8例(26.7%),其中胸痛1例,低热5例,恶心呕吐2例;对照组术后出现不良反应12例(40%),其中灌注后胸痛5例,发热4例,恶心呕吐3例。两组不良反应发生率差异无统计学意义(P>0.05)。所有患者出现不良反应后予对症治疗后症状均缓解。结论应用循环胸腔热灌注化疗治疗恶性胸腔积液安全有效,值得临床推广。

Objective To investigate the effects of continuous intrapleural hyperthermochemotherapy perfusion in the treatment of malignant pleural effusion （MPE）. Methods A total of 60 patients suffering MPE have been diagnosed, and randomly separated into 2 groups ： the observation group was treated with hyper- thermia combined with distilled water 2 00Oral plus eisplatin 200mg/m2 and sustained 60 minutes, and the con- trol group received sterile talcum 5g intrapleural injection. After treatment, the response rates and KPS scores were observed. Results The total effective rate of the observation group was 83.3% （25/30）, the KPS score improved rate of 73.3% （22/30） ; The total effective rate of the control group was 43.3% （13/30） ,the KPS increasing rate was 46.7% （14/30）. The total effective rate and the KPS score increasing rate of the observa- tion group were significantly better than that of the control group with P = 0. 001 and P = 0.035 respectively. Conclusion Continuous intrapleural hyperthermochemotherapy perfusion is a safe and effective treatment for malignant pleural effusion patients.