小剂量顺铂胸腔化疗联合胸腔穿刺引流治疗恶性胸腔积液的效果观察

Effect of low-dose cisplatin pleural chemotherapy combined with thoracic puncture drainage on malignant pleural effusion

目的观察小剂量顺铂胸腔化疗联合胸腔穿刺引流治疗恶性胸腔积液的效果及不良反应。方法将永州市中心医院2014年至2017年收治的45例大量胸腔积液患者按患者意愿分为治疗组及对照组,治疗组25例,对照组20例。对照组给予胸腔穿刺引流,胸腔积液引流干净后继续单纯胸腔引流积液,每周1次,连续3周。治疗组给予胸腔穿刺引流,胸腔积液引流干净后,予小剂量顺铂胸腔化疗(顺铂30mg/m2)联合胸腔引流积液,每周1次,连续3周。记录两组患者胸腔积液控制情况,生活质量变化及治疗组的不良反应情况。结果治疗组有效率高于对照组(48%比10%),患者生活质量提高(52%比15%),且不良反应轻,差异有统计学意义(P<0.05)。结论小剂量顺铂胸腔化疗联合胸腔穿刺引流能控制恶性胸腔积液,患者耐受性好,有一定的临床应用价值。

Objective To observe the efficacy and side effects of low-dose cisplatin pleural chemotherapy combined with thoracic puncture drainage on malignant pleural effusion.Methods Forty-five patients with pleural effusion admitted to Yongzhou Central Hospital from 2014 to 2017 were divided into treatment group and control group according to patients’wishes,with 25 patients in treatment group and 20 cases in control group.The control group received thoracic puncture and drainage.After thoracic effusion drainage was clean,the control group continued simple thoracic effusion drainage once a week for 3 weeks.The treatment group received thoracic puncture and drainage.After thoracic effusion drainage was clean,the treatment group was given low-dose cisplatin chemotherapy(cisplatin 30 mg/m2)combined with pleural effusion drainage once a week for 3 weeks.The control of pleural effusion,quality of life and adverse reactions of the two groups were recorded.Results The effective rate of the treatment group was significantly higher than that of the control group(48%vs.10%),the quality of life of the patients was significantly improved(52%vs.15%)and the adverse reactions were mild(P<0.05).Conclusions Low-dose cisplatin combined with thoracic puncture and drainage can control malignant pleural effusion,which is well tolerated by patients and has certain clinical application value.