胸腔循环热灌注化疗恶性胸腔积液的疗效观察和护理

目的观察并总结胸腔循环热灌注（IPH）化疗恶性胸腔积液的疗效、不良反应和护理。方法46例恶性胸腔积液的患者均采用RHL-2000型体腔循环热灌注机进行胸腔热灌注化疗。灌注液为0．9％氯化钠液2000m1加顺铂60—120mg，流量80-100ml／min，灌注时间60rain。治疗中及治疗后加强观察和护理。结果所有患者均成功接受了胸腔热灌注化疗，入胸腔水温[（42．80±0．25）℃]与出胸腔水温[（40．51±0．24）℃]。其中完全缓解（CR）16例，部分缓解（PR）21N，无效（NC）9例。热灌注顺铂治疗恶性胸腔积液的胸水控制有效率为80．4％，顺铂毒副反应轻微。结论应用胸腔循环热灌注联合顺铂治疗恶性胸腔积液能显著增强顺铂毒性作用，安全性高，顺铂毒副反应低，采取综合护理可提高胸腔循环热灌注的安全性，近期疗效满意。

Objective To observe and summarize the efficacy, adverse effects and nursing of circular intrapleural hyperthermic perfusion （IPH） chemotherapy in the treatment of malignant pleural effusion. Methods Forty-six patients with malignant pleural effusion were treated with RHL- 2000 visceral cavity hyperthermic perfusion machine for IPH chemotherapy. Perfusion solution was consisted of cisplatin 60-120mg, diluted in 2000ml physiologic saline which continuously irrigated the pleural cavity for 1 h with the speed of 80-100ml/min. Observation and nursing were conducted during and after treatment. Results All patients were successfully treated with IPH chemotherapy, and the water temperature at the entrance and exit of pleural cavity were （ 42.80 ± 0.25 ） ℃ and （ 40.51 ± 0.24 ） ℃, respectively. The overall response rate of IPH chemotherapy with cisplatin in the treatment of malignant pleural effusion was 80.4%, with complete remission 16 cases, partial remission 21 cases and non change 9 cases. The toxicity of cisplatin was mild. Conclusion The combination of IPH and cisplatin can improve the efficacy and decrease the toxicity in treatment of malignant pleural effusion. The comprehensive nursing can improve the safety of IPH with satisfied short-term effect.