rmhTNF二次治疗恶性胸腔积液的疗效观察

Observation of Curative Effect of rmhTNF Second Treatment for Malignant Pleural Effusion

目的探讨重组改构人肿瘤坏死因子(天恩福)rmhTNF二次治疗恶性胸腔积液的疗效和不良反应。方法选择20例因恶性胸腔积液首次经rmhTNF治疗有效后又复发的患者,患者排尽胸腔积液后,注入生理盐水30 ml+rmhTNF 300万IU,于第4,7,10天分别放开引流管,接引流袋,至胸腹腔液不再流出时拔管,并注入rmhTNF300万IU和30 ml生理盐水。然后观察患者用药后KPS评分以及客观疗效及不良反应。结果 20例患者经rmhTNF二次治疗后CR 4例,PR 12例,SD 3例,PD 1例,RR 80%,CBR 95%。其中,首次治疗达CR患者经rmhTNF胸腔注射二次治疗后50%达CR,50%达PR,RR达100%;首次治疗达PR患者二次治疗后,66.7%达PR,RR达66.7%,CBR达91.7%;7例血性胸腔积液全部变为黄色。患者生活质量有不同程度提高且均未出现明显的不良反应。结论 rmhTNF二次治疗恶性胸腔积液疗效可靠、无明显副作用,是治疗复发性恶性胸腔积液的有效手段之一。

Objective To study the efficacy and adverse reactions of rmhTNF second treatment for malignant pleural effusion. Methods 20 patients with malignant pleural effusion after the effective treatment of rmhTNF（ CR ＋ PR） and then relapsed were selected. Patients drained pleural effusion after injection of normal saline 3 million IU 30 ml ＋ rmhTNF,4,7,10 days respectively open drainage tube connected with a drainage bag to the chest,peritoneal fluid does not flow when extubation,and injection of rmhTNF300 000 IU and 30 ml saline. Then the observation of patients after treatment KPS score objective effect and adverse reaction were observed. Results 20 cases of patients with rmhTNF second treatment,CR was 4 cases,PR 12 cases,SD 3 cases,PD 1 cases,RR 80%,CBR 95%. Among them,CR patients after the first treatment and rmhTNF intrapleural injection 50%was CR,50% PR,RR 100%;patients with PR after the first treatment,66. 7% was PR,RR 66. 7%,CBR 91. 7%;7 cases of pleural effusion all turned into yellow. The quality of life of the patients improved in different degrees and there was no obvious adverse reaction. Conclusion The rmhTNF second treatment for malignant pleural effusion is reliable with no obvious side effect,is one of the most effective methods for recurrent malignant pleural effusion.