含恶性浆膜腔积液的肿瘤患者引流后局部灌注治疗的疗效分析

Analysis of the effect of local perfusion after drainage in patients with malignant serous effusion

目的:通过总结80例中晚期恶性肿瘤合并恶性浆膜腔积液患者的局部灌注方法及治疗效果,分析影响恶性浆膜腔积液临床获益的影响因素,以期更好地指导临床实践。方法:回顾性分析2012年8月—2017年2月80例有恶性浆膜腔积液、未行放化疗等抗肿瘤治疗措施患者的临床资料,计算并比较有效率和临床获益率。结果:80例经局部灌注治疗后完全缓解13例,部分缓解20例,稳定25例,无效22例,有效率为41. 25%,临床获益率为72. 50%。影响临床获益率的相关因素中,年龄、性别、卡氏评分(KPS)同疗效无明显相关性,而积液部位、组织来源为影响疗效的因素。局部灌注金葡素12 m L+重组改构肿瘤坏死因子200万U的患者有较好的临床有效率。结论:恶性浆膜腔积液引流后结合局部灌注金葡素联合重组改构肿瘤坏死因子,在不明显增加不良反应的同时,较为有效地控制了恶性浆膜腔积液的生成。

Objective：To summary the local perfusion method and effect of 80 cases with malignant serous effusion in hospital.The purpose of it was to analyze the factors affecting the clinical benefit of malignant effusions,in order to guide the clinical practice.Methods：The clinical data of 80 patients with anti-tumor treatments including malignant serous effusion and no radiotherapy and chemotherapy were analyzed retrospectively from August 2012 to February 2017.Calculate and compare the efficiency and clinical benefit rates.Results：All 80 cases received local perfusion treatment,13 cases got complete remission,20 cases got partial remission,25 cases got stability,22 cases got progress,the effective rate was 41.25%,the clinical benefit rate was 72.50%.Among the related factors,the age,sex and Karnofsky （KPS） score were not related to the curative effect,but the location of the effusion and the source of the tissue were the factors influencing the curative effect.Local instillation of stimulin 12 mL and rmhTNF 2 million had a favorable benefit.Conclusion：Stimulin and rmhTNF were efficitive in controlling the drainage of malignant serous cavity effusion without significant adverse reaction.