微创置管在恶性胸腔积液和心包积液治疗中的应用

Minimal-trauma tube installation in treatment of malignant thoracic and pericardiac effusion

目的 :探讨用中心静脉导管置管引流治疗恶性胸腔积液或心包积液的方法及疗效 .方法 :对临床确诊的恶性胸腔积液 (n =4 6 )和心包积液 (n =1 3)患者 ,随机分为微创置管组 (n =2 9)和常规穿刺组 (n =30 ) ,同时于胸腔或心包腔内注入顺铂 (4 5mg和 1 0mg/m2 ) .结果 :对于恶性胸腔积液患者 ,微创置管组的疗效明显优于常规穿刺组 (86 .4 %vs 5 4 .2 % ,P <0 .0 5 ) ;对于心包积液患者 ,微创置管组的疗效与常规穿刺组相差不显著 (71 .4 %vs 5 0 .0 % ,P >0 .0 5 ) .但所有病例中微创置管组均较常规穿刺组的副作用及并发症低 ,也能较好改善生活质量 (86 .2 %vs 5 3.3% ,P <0 .0 5 ) .结论 :中心静脉导管置管引流具有创伤小、操作简便安全、疗效较好等优点 。

AIM: To explore the method and effect of central venous duct installation in treating patients with malignant thoracic and pericardiac effusion. METHODS: Fifty nine patients, who were diagnosed as having malignant thoracic ( n = 46) or pericardiac effusion ( n =13), were divided into two groups at random: Minimal trauma tube installation group ( n =29) and routine puncturing group ( n =30). Cisplatin (45mg or 10 mg/m 2) was injected into the cavities of the subjects. RESULTS: For the patients with malignant thoracic effusion, the therapeutic effects of minimal trauma tube installation group were superior to those of routine puncturing group(86.4% vs 54.2%, P <0.05), while for the patients with pericardiac effusion, there was no remarkable statistical significance(71.4% vs 50.0%, P > 0.05). But for all patients, the side effects and complications of minimal trauma tube installation group were lower than those of routine puncturing group, and minimal trauma tube installation could improve the quality of patients life(86.2% vs 53.3%, P <0.01). CONCLUSION: Central venous duct installation is proved to be simple and effective in treating patients with thoracic and pericardiac effusion. Central venous duct installation not only causes minimal trauma but also improves the quality of patients life.