多发性骨髓瘤性胸腔积液七例临床分析

Clinical analysis of multiple myeloma pleural effusion in 7 cases

目的通过分析多发性骨髓瘤性胸腔积液患者的临床特点及疗效,为此类患者治疗提供更多思路及方法。方法回顾性分析甘肃省人民医院2010年1月至2019年1月期间就诊的7例多发性骨髓瘤性胸腔积液患者的病例资料。结果 7例根据胸腔积液脱落细胞学和(或)流式细胞术检测诊断,其中IgG型5例,Ig A型2例;7例患者均于我科行化疗并给予胸腔穿刺抽液缓解症状以及给予胸腔内顺铂、地塞米松灌注化疗,至今存活2例,死亡4例,1例失访。结论骨髓瘤性胸腔积液患者较为罕见,该类患者治疗效果差,预后不良,其发病机制尚需进一步研究;给予全身化疗、胸腔积液引流并联合胸腔灌注可能会改善患者预后。

Objective To analyze the clinical characteristics and efficacy of patients with multiple myelomatous pleural effusion, in order to provide more ideas and methods for the treatment of such patients. Methods The clinical data of 7 patients with multiple myeloma pleural effusion treated in the People's Hospital of Gansu Province from January 2010 to January 2019 were retrospectively analyzed. Results According to exfoliated cytology and/or flow cytometry of pleural effusion, 5 of the 7 cases were diagnosed as IgG type and 2 were IgA type. All the 7 patients received chemotherapy, thoracic puncture and drainage (to alleviate symptoms), and thoracic perfusion therapy with DDP and dexamethasone, of which 2 survived, 4 died, and 1 was lost in the follow-up. Conclusion Myelomatous pleural effusion is a rare disease with poor therapeutic effect and poor prognosis. Its pathogenesis remains to be further studied. Systemic chemotherapy, pleural effusion drainage, and thoracic perfusion may improve the prognosis of patients.