顺铂序贯重组人血管内皮抑制素胸腔灌注治疗恶性胸腔积液效果观察

Efficacy observation of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion

目的探讨顺铂序贯重组人血管内皮抑制素胸腔灌注治疗恶性胸腔积液的疗效。方法选取2018年1月至2021年2月茂名市人民医院收治的80例恶性胸腔积液患者,按随机数字表法分为对照组与研究组,每组各40例。对照组给予小口径导管微创引流联合顺铂胸腔灌注,研究组给予小口径导管微创引流联合顺铂序贯重组人血管内皮抑制素胸腔灌注。比较两组患者疗效、血管内皮生长因子表达、疼痛程度及不良反应情况。结果研究组治疗有效率高于对照组[90%(36/40)比75%(30/40)],差异有统计学意义(χ^(2)=5.04,P<0.05)。治疗后研究组胸腔积液及血清中血管内皮生长因子水平均低于对照组[(304±106)pg/ml比(598±159)pg/ml,(103±43)pg/ml比(189±49)pg/ml],差异均有统计学意义(t=6.62,P<0.001;t=6.23,P<0.001)。治疗后研究组视觉模拟评分法(VAS)评分低于对照组[(3.7±0.3)分比(4.4±0.7)分],差异有统计学意义(t=2.10,P<0.05)。两组患者胸痛、发热、恶心、呕吐发生率差异均无统计学意义(均P>0.05)。结论顺铂序贯重组人血管内皮抑制素胸腔灌注联合小口径导管微创引流能有效改善恶性胸腔积液患者临床症状,抑制血管内皮生长因子表达,减轻患者疼痛,且无明显不良反应。

Objective To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods A total of 80 patients with malignant pleural effusion in Maoming People′s Hospital from January 2018 to February 2021 were enrolled,and all patients were divided into 2 groups according to the random number table methods,each group with 40 cases.The control group was treated with small‑bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion,and the study group was treated with small‑bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion.And then the clinical efficacy,expressions of vascular endothelial growth factor(VEGF)expression,pain degree and adverse reactions were compared of both groups.Results The treatment efficacy rate of the study group was higher than that of the control group[90%(36/40)vs.75%(30/40)],and the difference was statistically significant(χ^(2)=5.04,P<0.05).After treatment,the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group[(304±106)pg/ml vs.(598±159)pg/ml,(103±43)pg/ml vs.(189±49)pg/ml],and the difference was statistically significant(t=6.62,P<0.001;t=6.23,P<0.001).After treatment,the visual analogue scale(VAS)score of the study group was lower than that of the control group[(3.7±0.3)scores vs.(4.4±0.7)scores],and the difference was statistically significant(t=2.10,P<0.05).The incidence of adverse reactions including stethalgia,fever,nausea and vomiting in both groups had no statistically significant differences(all P>0.05).Conclusions Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small‑bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms,inhibit the expression of VEGF,and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.