Hepatic hydrothorax:An update and review of the literature

This review considers the modern concepts of pathogenesis,diagnostic methods,and treatment principles of hepatic hydrothorax(HH).HH is the excessive(>500 mL)accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases.It causes respiratory failure which aggravates the clinical course of liver cirrhosis,and the emergence of spontaneous bacterial pleural empyema may be the cause of death.The information was collected from the PubM ed database,the Google Scholar retrieval system,the Cochrane reviews,and the reference lists from relevant publications for 1994-2016 using the keywords:"liver cirrhosis","portal hypertension","hepatic hydrothorax","pathogenesis","diagnostics",and"treatment".To limit the scope of this review,only articles dealing with uncomplicated hydrothorax in patients with liver cirrhosis were included.The analysis of the data showed that despite the progress of modern hepatology,the presence of HH is associated with poor prognosis and high mortality.Most patients suffering from it are candidates for orthotopic liver transplantation.In routine clinical practice,stratification of the risk for an adverse outcome and the subsequent determination of individual therapeutic strategies may be the keys to the successful management of the patient’s condition.The development of pathogenetic pharmacotherapy and optimization of minimally invasive treatment will improve the quality of life and increase the survival rate among patients with HH.

A fascinating presentation of hepatic hydrothorax

We report this case of a 43-year-old woman with hepatitis-C cirrhosis who presented with a large right sided pleural effusion complicated by hypoxic respiratory failure and altered mentation necessitating dependence on mechanical ventilation. The pleural effusion spontaneously resolved upon initiation of mechanical positive pressure ventilation and recurred almost immediately after weaning the patient off the ventilator. The preventilation, ventilation and post-ventilation chest X-ray films in chronological order present a striking visual demonstration of fluid dynamics and pathophysiology of hepatic hydrothorax, thereby obviating the need for a dedicated diagnostic test. We also report this case to highlight the treatment strategies for this often intractable complication.

High power focused-beam microwave hyperthermia combined with intrapleural injection of Shapeilin in the treatment of patients with malignant hydrothorax

Objective:The aim of the study was to evaluate the efficacy and toxicity of high power focused-beam microwave hyperthermia with intrapleural injection of Shapeilin for patients with malignant hydrothorax.Methods:Fifty-eight patients with malignant hydrothorax were divided into group A and group B randomly.All patients underwent indwelling pleural catheter and were treated by intrapleural injection of Shapeilin once three days.Treatment was composed of 3 times injection.Patients of group B received high power focused-beam microwave hyperthermia after injection of Shapeilin.Results:The response rate of group B(79.3%) was higher than that of group A(48.3%)(P < 0.05).Incidence of main adverse reactions,associated with Shapeilin,of two groups including fever and thoracodynia were similar(P > 0.05).Patients of group B didn't encounter severe toxicities of microwave hyperthermia.Conclusion:High power focused-beam microwave hyperthermia combined with intrapleural injection of Shapeilin is effective and tolerable for patients with malignant hydrothorax.

A Clinical observation of the therapy for malignant hydrothorax by intra-thoracic injection using IL-2 combining with Cisplatin

Objective: The aim of our study was to explore the short-term effects and complication of interleukin-2 (IL-2) combining with Cisplatin in the treatment of malignant hydrothorax.Methods: Sixty-two cases patients with malignant hydrothorax were randomly divided into two groups.Observation group was 31 examples,thoracic cavity injection IL-2 and Cisplatin;31 cases in control group using Cisplatin alone intra-thoracic injection.The regime of every week for 1–4 weeks was used to observe short term effects and complications.Results: The total response rate in observe group was higher than that in control group (90.3% vs.68.1%),which had statistically significant difference (P < 0.05).The complications included gastrointestinal tract reaction,bone marrow inhibition,chest pain and fever.The incidence rates of chest pain and fever in observe group was slightly higher than that in control group,but there was no statistically significant difference (P > 0.05).Conclusion: The IL-2 combining with Cisplatin intra-thoracic injection for malignant hydrothorax has the features of good therapeutic effects and slight poisonous side effects,which is worth to be used in clinic.

Evaluating factors associated with the risk of hydrothorax following standard supracostal percutaneous nephrolithotomy

Objective:To report our experience with supracostal percutaneous nephrolithotomy(SC-PNL)and evaluate factors which could predict the risk of hydrothorax following SC-PNL.Methods:We reviewed 347 patients who underwent SC-PNL from January 2011 to December 2019.Patients were assessed for demographic characteristics,indication for the supracostal access,level of supracostal access,anatomy of the kidney(normal or malrotated),site of the puncture in relation to the mid-scapular line(medial or lateral),and whether another subcostal tract for stone clearance was required or not.Patients were assessed for the incidence of hydrothorax and requirement of intercostal drain depending on the level of percutaneous access.In addition,a multivariable logistic regression analysis model was developed to identify factors which could predict the occurrence of hydrothorax following SC-PNL.Results:Of the 347 patients with SC-PNL,248(71.5%)underwent a supra-12th rib approach,while the rest needed a supra-11th(n=85;24.5%)or a supra-10th(n=14;4.0%)rib tract.Overall,17(4.9%)patients developed a hydrothorax,while an intercostal-drain was required in seven of these 17 patients for 48 h.None of the patients with a supra-12th rib puncture required an intercostal-drain.More than a third of the patients with a supra-10th puncture developed a hydrothorax(35.7%)and all of them required an intercostal drain.Factors such as anteriorly malrotated kidney(odds ratio[OR]=2.722;95%confidence interval[CI]=1.042-5.617,p=0.03),puncture medial to the mid-scapular line(OR=1.669;CI=0.542-1.578,p=0.03),and an access higher than the supra-12th level(OR=5.265;CI=1.292-9.342,p<0.001)proved to be independent predictors of hydrothorax following a SC-PCNL on multivariable analysis.Conclusion:Incidence of clinically significant hydrothorax requiring an intercostal-drain after SC-PNL is very low.Knowledge of the predicting factors will help to anticipate the risk of hydrothorax in a particular patient and take necessary peri-operative measures.

Transjugular intrahepatic portosystemic stent shunt for medically refractory hepatic hydrothorax:A systematic review and cumulative meta-analysis

AIM:To assess the effectiveness of transjugular intrahepatic portosystemic stent shunt(TIPSS) in refractory hepatic hydrothorax(RHH) in a systematic review and cumulative meta-analysis.METHODS:A comprehensive literature search was conducted on MEDLINE,EMBASE,and Pub Med covering the period from January 1970 to August 2014.Two authors independently selected and abstracted data from eligible studies.Data were summarized using a random-effects model.Heterogeneity was assessed using the I2 test.RESULTS:Six studies involving a total of 198 patients were included in the analysis.The mean(SD) age of patients was 56(1.8) years.Most patients(56.9%) had Child-Turcott-Pugh class C disease.The mean duration of follow-up was 10 mo(range,5.7-16 mo).Response to TIPSS was complete in 55.8%(95%CI:44.7%-66.9%),partial in 17.6%(95%CI:10.9%-24.2%),and absent in 21.2%(95%CI:14.2%-28.3%).The mean change in hepatic venous pressure gradient post-TIPSS was 12.7 mm Hg.The incidence of TIPSS-related encephalopathy was 11.7%(95%CI:6.3%-17.2%),and the 45-d mortality was 17.7%(95%CI:11.34%-24.13%).CONCLUSION:TIPSS is associated with a clinically relevant response in RHH.TIPSS should be considered early in these patients,given its poor prognosis.

Application value of ATP based bioluminescence tumor chemosensitivity assay in the chemotherapy for hydrothorax caused by non-small cell lung cancer

Objective： The aim of the study was to investigate the clinical value and application of ATP based bioluminescence tumor chemosensitivity assay （ATP-TCA） in the chemotherapy for hydrothorax caused by non-small cell lung cancer （NSCLC）. Methods： Hydrothorax specimens from 120 NSCLC patients were analyzed by ATP-TCA and the most sensitive chemotherapeutic drugs were used in NSCLC patients （treatment group）. At the same time, 56 NSCLC patients with hydrethorax were admitted in our Hospital （Department of Oncology, The No. 2 People＇s Hospital of Yibin, China） and given chemotherapy without guidance of the ATP-TCA （control group）. Before the third chemotherapeutic cycle, clinical outcomes were analyzed in the two groups. Results： Effective rate of hydrothorax in treatment group was 67%, while 46% in control group （P 〈 0.05）. In refractory hydrothorax patients, they were 69% and 40% （P 〈 0.05）, respectively.In vitro results correlated well with clinical outcomes （P 〈 0.01）. Conclusion： Effective rate of chemotherapy for hydrothorax in NSCLC is higher in treatment group than that in control group. ATP-TCA is especially helpful for refractory hydrothorax.

Apatinib,S-1 Combined with Paclitaxel Perfusion in the Treatment of Malignant Seroperitoneum of Gastric Cancer

Objective:To analyze the effect of apatinib,S-1 combined with paclitaxel perfusion on malignant seroperitoneum of gastric cancer.Methods:From December 2019 to May 2020,172 patients with gastric cancer treated in our hospital were randomly divided into two groups:observation group and control group,86 cases each.The control group adopted the method of S-1 combined with paclitaxel perfusion therapy in the treatment of malignant seroperitoneum of gastric cancer.The observation group was given oral apatinib on the basis of S-1 combined with paclitaxel perfusion therapy,and the dosage was 500 mg/d.Results:The total effective treatment in the control group was 43.02%,while the total effective rate in the observation group was 69.77%;the drug resistance of the two groups of patients increased and the adverse reactions were low.Conclusion:Apatinib and S-1 combined with paclitaxel perfusion therapy can effectively improve the treatment effect,stabilize the patient's condition,increase the patient's drug resistance to adverse reactions,and have a good prognosis.

Bi-directional hepatic hydrothorax

A 59-year-old male with alcoholic cirrhosis presented to our hospital with an acutely painful umbilical hernia,and 4 mo of exertional dyspnea.He was noted to be tachypneic and hypoxic.He had a massive right sided pleural effusion with leftward mediastinal shift and gross ascites,with a tense,fluid-filled,umbilical hernia.Emergent paracentesis with drain placement and a large volume thoracentesis were performed.Despite improvement in dyspnea and drainage of 15 L of ascitic fluid,the massive transudative pleural effusion remained largely unchanged.He underwent a repeat large volume thoracentesis on hospital day 4.The patient subsequently developed a tension pneumothorax,which resulted in a dramatic reduction in the effusion.A chest tube was placed and serial radiographs demonstrated resolution of the pneumothorax but recurrence of the effusion.The radiographs illustrate the movement of fluid between the peritoneal and pleural cavities.In this case,the mechanism of pleural effusion was confirmed to be a hepatic hydrothorax via an unintended tension pneumothorax.Methods to elucidate a hepatic hydrothorax include Tc99m or indocyanine green injection into the ascitic fluid followed by its demonstration above the diaphragm.The unintended tension pneumothorax in this case additionally demonstrates bi-directional flow across the diaphragm.

Hepatic hydrothorax occurring rapidly after manual abdominal compression

Hepatic hydrothorax is a relatively infrequent but po- tentially serious complication of liver cirrhosis that often causes respiratory dysfunction. Several hypotheses for the development of hepatic hydrothorax have been sug- gested to explain a transdiaphragmatic shift of ascitic fluid through small defects between the peritoneal cavity and the pleural space. However, the rapid development of hydrothorax within several hours is seldom encoun- tered. In addition, the causal factors for rapid passage of ascitic fluid into the pleural cavity are unknown. This report describes a patient with liver cirrhosis who suf- fered rapid development of a hydrothorax after manual compression of the abdomen.

Natural history and outcomes of patients with liver cirrhosis complicated by hepatic hydrothorax

BACKGROUNDHepatic hydrothorax (HH) is an uncommon and difficult-to-manage complicationof cirrhosis with limited treatment options.AIMTo define the clinical outcomes of patients presenting with HH managed withcurrent standards-of-care and to identify factors associated with mortality.METHODSCirrhotic patients with HH presenting to 3 tertiary centres from 2010 to 2018 wereretrospectively identified. HH was defined as pleural effusion in the absence ofcardiopulmonary disease. The primary outcomes were overall and transplant-freesurvival at 12-mo after the index admission. Cox proportional hazards analysiswas used to determine factors associated with the primary outcomes.RESULTSOverall, 84 patients were included (mean age, 58 years) with a mean model forend-stage liver disease score of 29. Management with diuretics alone achievedlong-term resolution of HH in only 12% patients. At least one thoracocentesis wasperformed in 73.8% patients, transjugular intrahepatic portosystemic shuntinsertion in 11.9% patients and 33% patients received liver transplantation within12-mo of index admission. Overall patient survival and transplant-free survival at12 mo were 68% and 41% respectively. At multivariable analysis, current smoking [hazard ratio (HR) = 8.65, 95% confidence interval (CI): 3.43-21.9, P < 0.001) and acute kidneyinjury (AKI) (HR = 2.91, 95%CI: 1.21-6.97, P = 0.017) were associated with a significantly increasedrisk of mortality.CONCLUSIONCirrhotic patients with HH are a challenging population with a poor 12-mo survival despitecurrent treatments. Current smoking and episodes of AKI are potential modifiable factors affectingsurvival. HH is often refractory of diuretic therapy and transplant assessment should beconsidered in all cases.

Successful treatment of hepatic hydrothorax: A case report

Rationale:Acute complications of cirrhosis can be life-threatening.One of the less common acute complications is hepatic hydrothorax whose medical management is rarely successful and is still controversial.Patient concerns:A 51-year-old patient presenting to the emergency room for a massive pleural effusion.Diagnosis:A hepatic hydrothorax with a placed chest tube whose removal was not possible.Interventions:Increased doses of diuretics with a strict salt-free diet.Outcomes:An improvement of the clinical state,with no recurrent pleural effusion up to one month.Lessons:Medical management of hepatic hydrothorax is possible.

Novel conservative treatment for peritoneal dialysis-related hydrothorax:Two case reports

BACKGROUND Peritoneal dialysis (PD) is an important renal replacement therapy for patientswith end-stage renal disease. PD-related hydrothorax is a rare but seriouscomplication in PD patients, produced by the movement of peritoneal dialysatethrough pleuroperitoneal fistulas. In previous reports, patients with hydrothoraxsecondary to PD were usually recommended to discontinue PD and transfer tohemodialysis (HD). Herein, we describe another method of managing thiscomplication—with an adjusted PD prescription and continuous drainage ofpleural effusion, patients could continue PD without recurrence of hydrothorax.CASE SUMMARY In this report, we present the medical records of 2 patients with hydrothoraxsecondary to PD. We recommended intermittent PD with continuous drainage ofpleural effusion. A type 18Ga soft catheter was placed to drain pleural effusion.Ultrasound-guided thoracentesis was performed, and the soft catheter was placedin the pleural cavity for a long period (3 mo and 2 mo, respectively). The pleuralcatheter was removed when no fluid was drained from the pleural cavity. Afterseveral months, pleuroperitoneal fistulas were closed in both patients and PD wascontinued. These patients did not transfer to HD, had no recurrence ofhydrothorax and were still treated with PD after 1 year.CONCLUSION These 2 case reports show that continuous drainage of pleural effusion with an18Ga soft catheter is a useful method for hydrothorax secondary to PD.

Human umbilical cord blood-derived mononuclear cell transplantation for umbilical hernia and hepatic hydrothorax in primary biliary cirrhosis

Cell therapy was proposed as a potential treatment intervention for liver cirrhosis recently due to the fact that the therapeutic protocol for primary biliary cirrhosis (PBC)-associated refractory umbilical hernia and hepatic hydrothorax is not well defined currently. We report herein the case of a 58-year-old woman who received routine treatments for PBC, which developed into an incarcerated hernia and uncontrolled hydrothorax. This subject’s condition was significantly improved and maintained stable condition after receiving human umbilical cord blood-derived mononuclear cell (CBMC) transplantation. Consequently, this new strategy may be a potential treatment option for the refractory umbilical hernia and hydrothorax caused by PBC. However, sufficient data from large-scale controlled and double-blinded clinical trials are needed to further confirm the treatment efficacy and longterm safety before this cell transplantation can be used as a regular therapy for liver cirrhosis.

肺淋巴管平滑肌瘤病一例并文献复习

肺淋巴管平滑肌瘤病(PLAM)发病率低,在临床上属于少见病,因其起病隐匿,无典型症状,影像学表现易与肺气肿混淆,在临床上容易漏诊、误诊。本例患者因咳嗽进行体检时偶然发现胸腔积液及双肺多发囊腔影,经肺活检明确诊断该病。本文通过对该病例的病史、辅助检查、诊断过程进行分析及对相关文献资料复习,总结出PLAM一些临床特征及治疗经验,以期提高广大医务工作者对该类疾病的诊疗水平。

胸腹水细胞蜡块制作的常见问题分析

目的针对胸腹水在细胞蜡块制作过程中几种常见问题探索合适的方法,提高蜡块的质量。方法分别收集2021年1月至2022年8月福建省肿瘤医院病理科在制作蜡块方面有困难的3种类型胸腹水标本,第1种为血性胸腹水标本,第2种为离心后细胞量较多细胞的标本,第3种为性状透明清亮或者胶冻状标本、离心后仅有微量可见的细胞标本,3种标本类型分为第1组、第2组、第3组,每组40例。每组均分为A、B两管,A管采用常规方法制作蜡块,B管分别采用不同的改良方法制作蜡块,最终比较三组A、B两管蜡块的质量。结果第1组B管解决了血性胸腹水镜下红细胞较多、有用细胞较少的问题;B管蜡块质量优于A管,差异有统计学意义(χ_(2)=72.381,P<0.001)。第2组B管解决了样本较多时制作出的蜡块较为松散,固定不佳,有用细胞流失的问题;B管蜡块制作难易度优于A管,差异有统计学意义(χ^(2)=45.113,P<0.001)。第3组B管解决了样本少、标本性状不佳无法包埋、脱水容易丢失、蜡块制作困难等难题;B管蜡块制作难易度优于A管,差异有统计学意义(χ^(2)=57.945,P<0.001)。结论通过蜡块制作中常见的几种问题,阐明了制作蜡块过程中,可以有针对性地对血性胸腹水使用新柏氏红细胞清洗液,标本量多的标本多1 h 95%酒精固定,量少的标本使用微量细胞蜡块包埋机制作,最大程度解决问题,制作出优质的细胞蜡块。

卵巢甲状腺肿2例临床分析

卵巢甲状腺肿临床少见,表现形式多样,容易漏诊,现根据本科2例卵巢甲状腺肿的临床诊治情况,探讨卵巢甲状腺肿的诊断、治疗及预后,为早发现、早诊断、早治疗提供依据。回顾性分析2例卵巢甲状腺肿患者的临床资料,依据不同的临床症状及体征采用不同的影像学检查,进而确定手术治疗方式,并评价治疗效果及预后情况。2例患者虽然临床表现不同,影像学检查也差别较大,但手术标本提示病理结果相同,都诊断为卵巢甲状腺肿,都能通过手术获得良好的治疗效果。通过分析发现,卵巢甲状腺肿患者拥有不同的临床表现及体征,影像学检查结果明显不同,因此在临床诊治过程中要全面考虑、及时手术、术中快速病理,以便采取恰当的手术方式,争取较好的疗效。

胸腔积液外泌体miR-506-3p联合腺苷脱氨酶检测在结核性胸膜炎的早期诊断及预后评估中的价值

目的 分析胸腔积液外泌体miR-506-3p联合腺苷脱氨酶(adenosine deaminase,ADA)在结核性胸膜炎的早期诊断及预后评估中的价值。方法 选取2021年8月至2023年3月就诊于沧州市人民医院的90例结核性胸膜炎患者作为结核组,另选同期于沧州市人民医院就诊的50例非结核性胸膜炎(肺炎旁胸腔积液、恶性胸腔积液等)患者作为非结核组,对比两组临床资料与胸腔积液外泌体miR-506-3p、ADA水平,经多因素Logistic回归分析影响结核性胸膜炎发生的危险因素。根据治疗3个月后患者预后情况,将结核组分为预后良好组(72例)、预后不良组(18例),对比两组胸腔积液外泌体miR-506-3p、ADA水平。经Pearson相关性分析,并绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线),分析胸腔积液外泌体miR-506-3p、ADA水平及二者联合预测结核性胸膜炎发生及患者预后的价值。结果 结核组患者胸腔积液ADA水平比非结核组高,胸腔积液外泌体miR-506-3p水平比非结核组低(P<0.05);经多因素Logistic回归分析发现,胸腔积液ADA水平高[OR=1.205(95%CI 1.105~1.313)]是结核性胸膜炎发生的危险因素(P<0.05),外泌体miR-506-3p水平高表达[OR=0.320(95%CI 0.158~0.658)]是结核性胸膜炎发生的保护因素(P<0.05);预后不良组患者胸腔积液ADA水平比预后良好组高,胸腔积液外泌体miR-506-3p水平比预后良好组低(P<0.05);绘制ROC曲线发现,胸腔积液ADA、外泌体miR-506-3p水平及二者联合预测结核性胸膜炎发生的曲线下面积(area under curve,AUC)为0.729(95%CI 0.640~0.818)、0.810(95%CI 0.738~0.883)、0.874(95%CI 0.818~0.930),预测结核性胸膜炎患者不良预后的AUC为0.892(95%CI 0.806~0.978)、0.924(95%CI 0.868~0.981)、0.942(95%CI 0.875~1.000);Pearson相关性显示,胸腔积液ADA与外泌体miR-506-3p水平呈负相关(r=-0.335,P=0.001)。结论 结核性胸膜炎患者胸腔积液外泌体miR-506-3p呈低表达、ADA呈高表达,二者之间为负相关,且miR-506-3p联合ADA可有效预测结核性胸膜炎患者不良预后的发生。

胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法在病理检测的价值

目的探讨与分析胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法在病理检测的价值。方法选取2019年3月—2022年9月在乌鲁木齐市中医医院诊治的92例胸腹水患者作为研究对象,所有患者都给予胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法,都给予病理活检,判断诊断的价值。结果在92例患者中,胸腹水液基细胞学检测判断为恶性肿瘤54例,良性肿瘤38例,胸腹水液基细胞学检测诊断恶性肿瘤的敏感度与特异度分别为85.48%、96.67%。胸腹水沉淀物琼脂石蜡双包埋切片检测判断为恶性肿瘤55例,良性肿瘤37例,胸腹水沉淀物琼脂石蜡双包埋切片检测诊断恶性肿瘤的敏感性与特异性分别为88.71%、100.00%。胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片检测判断为恶性肿瘤61例,良性肿瘤31例,胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片检测诊断恶性肿瘤的敏感度与特异度分别为98.39%、100.00%。恶性肿瘤患者的人表皮生长因子受体2、突触素、嗜铬素A表达阳性率分别为40.32%、41.94%、43.55%,与良性肿瘤患者的10.00%、13.33%、10.00%相比有显著提高,差异有统计学意义(P<0.05)。胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法对肿瘤良恶性的诊断敏感性高于单项检测,差异有统计学意义(P<0.05),不同检测方法的诊断特异性比较,差异无统计学意义(P>0.05)。ROC曲线分析显示,胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法对肿瘤良恶性的诊断曲线下面积为0.883。结论胸腹水液基细胞学检测联合胸腹水沉淀物琼脂石蜡双包埋切片法在病理检测中的应用能提高诊断敏感度,还可保持非常高的诊断特异度,对患者的原发肿瘤良恶性判定具有很好的价值。

腔内灌注化疗联合全身热疗治疗恶性胸腹腔积液临床研究

目的探讨腔内化疗联合全身热疗对恶性腔内积液的疗效及毒副作用。方法回顾分析64例胸腹水患者。分为A、B两组,A组34例为单纯腔内化疗组,行腔内中心静脉置管抽液后注入化疗药物,B组30例为热化疗组,行腔内置管抽液化疗联合全身热疗。两组均为每周1次共4次,评价两组患者的近期疗效及毒副作用。结果A组患者CR为29.41%(10/34),PR为32.35%(11/34),有效率(CR+PR)为61.76%,B组患者CR为46.67%(14/30),PR为40%(12/30),有效率(CR+PR)为86.67%,两组间比较差异有显著性(P=0.045)。毒副作用方面,消化道反应(I°+II°)与血液学毒性(I°+II°)两组间均无明显差异(P=1.000)。结论腔内灌注化疗联合全身热疗治疗恶性胸腹腔积液较单纯腔内化疗疗效高,耐受性良好。