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目的观察热疗联合胸腔置管化疗治疗恶性胸腔积液的临床疗效及其毒副反应。方法62例恶性胸腔积液患者随机分为射频热疗联合胸腔置管化疗组(治疗组)和单纯胸腔置管化疗组(对照组)各31例。对照组先行胸腔闭式引流后,将顺铂60 mg、氟尿嘧啶1.0 g、吡喃阿霉素40 mg各加生理盐水50 ml胸腔内注射,再将地塞米松20 mg胸腔内注射后夹管,每周1次,灌注2次后拔管观察,治疗组于胸腔注射药物后行热疗,当周再行1次单纯热疗,一疗程4次。结果对照组胸腔积液控制有效率为54.8%,治疗组为83.9%,两组差异有显著性(P<0.05)。对照组生活质量改善率为48.4%,治疗组为77.4%,两组差异有显著性(P<0.05)。两组化疗毒副反应发生率差异无显著性。与热疗相关的毒副反应为局部皮肤疼痛4例(13.0%),皮下脂肪硬结3例(9.7%)。结论热疗联合胸腔置管化疗治疗恶性胸腔积液是一种安全可靠、高效低毒的治疗方法,值得临床推广使用。
Objective To observe the clinical effect and toxicity of hyperthermia combined with thoracic tube chemotherapy in the treatment of malignant pleural effusion. Methods Totally 62 patients with malignant pleural effusion were randomly divided into radiofrequency thermotherapy combined with thoracic tube chemotherapy group (treatment group) and simple thoracic tube chemotherapy group (control group) each with 31 cases. Control group after thoracic drainage, cisplatin 60 mg, fluorouracil 1.0 g, pirarubicin 40 mg each plus saline 50 ml intrathoracic injection, and then dexamethasone 20 mg intrathoracic injection after the pinch, Weekly, perfusion 2 times after extubation observation, the treatment group in the thoracic cavity after the injection of hyperthermia, weekly rehearsal only 1 hyperthermia, a course of 4 times. Results The effective rate of control group was 54.8% for pleural effusion and 83.9% for treatment group. There was significant difference between the two groups (P <0.05). The improvement rate of quality of life in the control group was 48.4%, and the treatment group was 77.4%. There was significant difference between the two groups (P <0.05). There was no significant difference in the incidence of chemotherapy side effects between the two groups. Toxic side effects associated with hyperthermia were local skin pain in 4 cases (13.0%) and subcutaneous fat induration in 3 cases (9.7%). Conclusion Hyperthermia combined with thoracic tube chemotherapy for the treatment of malignant pleural effusion is a safe, reliable and efficient treatment of low toxicity, worthy of clinical promotion.