奈达铂与顺铂治疗非小细胞肺癌恶性胸腔积液的疗效及不良反应比较

Curative Effect and Adverse Reactions of Nedaplatin and Cisplatin for Non-small Cell Lung Cancer with Malignant Pleural Effusion

目的探究奈达铂与顺铂治疗非小细胞肺癌恶性胸腔积液的临床效果。方法选取84例非小细胞肺癌恶性胸腔积液患者为研究对象,按照随机数表法将患者平均分为2组,观察组和对照组,各42例。2组患者均进行肺癌的常规治疗,观察组胸腔灌注奈达铂进行治疗,对照组胸腔灌注顺铂进行治疗。每30天为1个周期,连续治疗1个周期后对患者的临床治疗效果进行比较;采用Karnofsky评分、生活自理能力自评量表(ADL)、改良式肢体运动功能量表(FMA)评估2组患者生活质量;对2组患者包括消化道症状、血尿素氮升高、中性粒细胞减少等多项治疗不良反应的发生情况进行比较。患者出院后对患者进行为期3年的出院随访,比较2组患者出院后1年、2年、3年的生存率,对2组患者平均生存期进行比较。结果观察组总体有效率(80.9%)显著高于对照组(61.9%),差异有统计学意义(P<0.05);观察组Karnofsky评分(87.3±5.0)、ADL评分(85.6±2.8)、FMA得分(81.8±4.1)均显著高于对照组。观察组各项不良反应发生率均低于对照组(P<0.05)。观察组患者出院后1、2、3年生存率及平均生存期均高于对照组(P<0.05)。结论与顺铂相比,奈达铂治疗非小细胞肺癌恶性胸腔积液临床效果更好,能够降低患者不良反应发生率,提高生存率,改善患者生活质量,临床可广泛推广使用。

Objective To study the clinical efficacy of nedaplatin and cisplatin in the treatment of non-small cell lung cancer with malignant pleural effusion. Methods 84 patients with malignant pleural effusion were divided into 2 groups according to the random number table. The observation group and the control group each with 42 cases. The 2 groups of patients received routine treatment of lung cancer,the observation group received thoracic infusion of nedaplatin for treatment,the control group of thoracic irrigation cisplatin for treatment.（ KL）,the self-rating scale（ ADL）,the modified limb motor function scale（ FMA） were used to evaluate the effect of the 2 groups（ P〈0. 05）. Quality of life of the 2 groups,including gastrointestinal symptoms,elevated blood urea nitrogen,neutropenia and other treatment of adverse reactions were compared. The patients were followed up for 3 years after discharge. The survival rate of the 2 groups was compared with the average survival time of the 2 groups after 1 year,2 years and 3 years of discharge. Results The overall effective rate（ 80. 9%） was significantly higher in the observation group than in the control group（ 61. 9%）,the difference was statistically significant（ P〈0. 05）; the Karnofsky score（ 87. 3 ± 5. 0）,the ADL score（ 85. 6 ± 2. 8） Score（ 81. 8 ± 4. 1） were significantly higher than the control group. The incidence of adverse reactions in the observation group was lower than that of the control group（ P〈0. 05）. The survival rate and mean survival time of the observation group were higher than those of the control group at 1,2 and 3 years after discharge（ P〈0. 05）. Conclusion Nedaplatin in the treatment of non-small cell lung cancer with malignant pleural effusion has better clinical efficacy,can reduce the incidence of adverse reactions in patients,improve the quality of life of patients,it is worthy of clinical promotion.