沙培林联合羟基喜树碱腔内给药治疗恶性胸腔积液

Intrapleural therapy with OK-432 and HCPT in malignant pleural effusion

目的:为观察沙培林联合羟基喜树碱腔内给药治疗恶性胸腔积液患者的治疗。方法:60例恶性胸腔积液患者采用胸腔穿刺,使用比利时生产的贝朗可分裂中心静脉导管置入胸腔、接负压瓶持续闭式引流排胸液。并随机分成两组,治疗组采用沙培林联合羟基喜树碱治疗(30例),第一周2次,每隔3天一次,由引流管住入生理盐水40ml加羟基喜树碱30mg,第2周连续3天注入沙培林5KE/次、10KE/次、10KE/次,对照组单用羟基喜树碱治疗(30例),每一周2次,每隔3天一次,由引流管注入生理盐水40ml加羟基喜树碱30mg。结果:治疗组有效率90％[CR11例(37％)+PR 16例(53％)],对照组有效率 67％[CR 8例(27％)+PR 12例(40％)]。结论:沙培林联合羟基喜树碱腔内注射治疗恶性胸腔积液优于单用羟基喜树碱,而胸腔穿刺置管引流创伤轻微,无倒流污染,引流通畅彻底,避免胸膜多房性包裹粘连的形成以至带来后续治疗困难,可防止医源性感染及气胸等并发症。

Objective:To observe the efficacy of OK-432 and HCPT for the patients with malignant pleural effusion. Methods: We randomized 60 patients with malignant pleural effusion into two groups, then place the P1CC tube which was made in Belgium into the patient's pleural cavity by pleurocentesis, and connect it with negative pressure bottle to drain continuously. In the treatment group(30 patients) , introplerual therapy with HCPT 30mg on day 1 and day 4 in the first week, intropleural injection of OK-432 5 KE, 10KK, 10KE on day 1 to day 3 in the second week; In the control group, we only inject HCPT 30mg into the pleural cavity on day 1 and day 4 in the first week. Results:The result was that the response rate of treatment group is 90% [ CR in 11 patients(37% ) + PR in 16 patients(53% ) ] , the response rate of control group is 67% [CR in 8 patients (27% ) + PR in 12 patients (40% ) ] , combined therapy with OK-432 and HCPT were superior to single drug of HCPT in patients with malignant pleural effusion. Conclusion: This method had advantage in less injury, no backflow pollution,draining completely, preventing the adhesion and encapsulation of pleura which would increase the difficulty of follow treatment, decrease the cases of complication such as clinical source infection and pheumo-thorax.