留置中心静脉导管联合胸腔局部治疗恶性胸腔积液近期疗效分析

ANALYSIS OF THE NEAR FUTURE CURATIVE EFFECT OF JOINT INDWELLING CENTRAL VENOUS CATHETER PLEURAL LOCAL TREATMENT OF MALIGNANT PLEURAL EFFUSION

目的采取中心静脉导管置管引流联合胸腔局部治疗,评估综合治疗恶性肿瘤患者伴恶性胸腔积液的近期临床疗效。方法 2012年5月—2014年10月收集恶性肿瘤伴恶性胸腔积液的84例患者,采用随机对照的方法划分为观察组56例和对照组28例。对照组行全身静脉化疗配合胸腔内放置中心静脉导管引流;观察组在对照组治疗的基础上,行胸腔局部治疗,具体措施包括:胸腔注入抗肿瘤药物、胸腔注入生物反应调节剂、胸膜粘连术等综合疗法。结果二组患者中有3例患者出现胸膜反应,5例患者出现发热症状,给予积极对症支持治疗后缓解,其余患者均顺利完成治疗,未发生严重得并发症,观察组胸腔积液缓解总有效率达76.79%,生活质量KPS评分较高,患者无进展生存期(PFS)和总生存期(OS)明显延长。结论胸腔穿刺抽液术联合胸腔局部治疗的综合疗法,对恶性肿瘤患者出现恶性胸腔积液疗效确切,一方面能明显改善患者呼吸系统的症状,提高肿瘤患者的生活质量;另一方面可一定程度上延长恶性肿瘤患者无进展生存期(PFS)和总生存期(OS)。值得进一步做大样本临床观察与研究。

Objective Take the central venous catheter drainage tube joint chest local treatment,evaluation of comprehensive treatment of malignant tumor patients with malignant pleural effusion recent clinical curative effect.Methods Our department from May 2012 to October 2014 collected 84 patients of malignant tumor with malignant pleural effusion,using randomized controlled statistical methods were divided into treatment group（56 cases and control group28 cases.Line in the control group given systemic vein chemotherapy with chest central venous catheter placed in the duct drainage;Treatment group with control group,on the basis of local treatment to line the chest,the specific measures include：the chest injection antitumor drugs,chest into the bioreactor regulator,pleural adhesions etc.Comprehensive therapy.Results The two groups of patients with pleural reaction observed in3 patients and 5 patients had symptoms of fever,actively suit the support after treatment,the rest of the patients were successfully completed treatment,there was no serious complications.The treatment group hydrothorax ease the total effective rate was 76.79%,and the quality of life KPS score was higher,the patient progression-free surial（PFS）and overall survival（OS）extended obviously.Conclusion The pleural puncture pumping fluid combined local treatment of the comprehensive treatment of the chest,appear the malignant pleural effusion efficacy in patients with malignant tumor,on the one hand,which can significantly improve patients with respiratory symptoms,improve the quality of life for cancer patients,on the other hand can be extended to a certain extent in patients with malignant tumor progression-free surial（PFS）and overall survival（OS）.It is worth doing further large sample clinical observation and research.