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目的比较胸腔内注射重组改构人肿瘤坏死因子、顺铂治疗肺腺癌胸腔积液的效果。方法从2006年6月—2009年10月,随机采用胸腔注射重组改构人肿瘤坏死因子和顺铂对78例肺腺癌胸腔积液患者进行治疗,观察两种药物的治疗效果及不良反应。结果重组改构人肿瘤坏死因子组41例,总有效率为70.73%(29/41),其中一次注射有效率为56.10%(23/41);顺铂组37例患者中总有效率43.24%(16/37),其中一次注射有效率为32.43%(12/37),两组一次注射有效率差异显著(P<0.05),总有效率差异显著(P<0.05)。不良反应:肿瘤坏死因子组有1例(2.43%)一过性发热,经对症治疗后体温降至正常。顺铂组有恶心呕吐Ⅰ级14例(37.84%),Ⅱ级4例(10.81%),白细胞数注药一周下降至正常以下有15例(40.54%)。结论胸腔内注射重组改构人肿瘤坏死因子治疗肺腺癌胸腔积液,与注射顺铂疗效相比,一次有效率和总有效率都高于顺铂,而不良反应明显较顺铂为小。
Objective To compare the effect of intrathoracic injection of reconstituted human tumor necrosis factor and cisplatin in the treatment of pleural effusion of lung adenocarcinoma. Methods From June 2006 to October 2009, 78 patients with pleural effusion of lung adenocarcinoma were treated by intrathoracic injection of recombinant human TNF and cisplatin. The therapeutic effects and adverse reactions of the two drugs were observed. Results The total effective rate was 70.73% (29/41) in 41 patients with recombinant TNF-α, the effective rate was 56.10% (23/41) in one injection and 43.24% in 37 patients in cisplatin group (16/37). The effective rate of one injection was 32.43% (12/37). There was significant difference between the two groups (P <0.05). The total effective rate was significantly different (P <0.05). Adverse reactions: Tumor necrosis factor group, 1 case (2.43%) had transient fever, after symptomatic treatment to normal body temperature. In the cisplatin group, 14 patients (37.84%) were grade Ⅰ in grade Ⅰ, 4 patients (10.81%) in grade Ⅱ, and 15 patients (40.54%) had number of leukocytes dropping to normal one week later. Conclusion Intrathoracic injection of recombinant human TNF-α in the treatment of pleural effusion of lung adenocarcinoma has a higher effective rate and higher total effective rate than cisplatin compared with cisplatin injection, but the adverse reaction is obviously lower than that of cisplatin.