摘要
目的探讨胸腔镜下胸腔内热灌注化疗对肺癌合并胸腔积液患者的治疗效果。方法44例肺癌合并胸腔积液患者分为治疗组(24例)和对照组(20例),治疗组于全麻下用胸腔镜探察胸腔,并行胸膜活检,用人工心肺机将预充液(NS3000ml+顺铂300mg)加热至42.0～44.0℃后,通过两根导管连接至胸腔内,循环灌注胸腔约60min。对照组予以胸腔引流后,将溶解有顺铂60～80mg的生理盐水50ml经胸管或中心静脉导管注入胸腔。比较两组治疗后胸腔积液的控制情况、KPS评分变化,生存率以及不良反应。结果治疗组和对照组的胸腔积液控制有效率分别为100%、60%,两组比较有显著性差异(P<0.05);治疗组和对照组KPS评分升高率分别为62.5%、30%,两组比较有显著性差异(P<0.05);治疗组和对照组1年生存率分别为70.8%、45%,两组比较有显著性差异(P<0.05),两组均未见明显的不良反应。结论胸腔镜辅助下胸腔内热灌注化疗具有快速诊断、创伤小、控制胸腔积液效果好、不良反应小的优点。
Objective To assess the comprehensive effective of pleural perfusion thermo - chemotherapy （ PPTC ） for malignant pleural effusion （MPE） caused by lung carcinoma under VATS. Methods 44 patients with MPE caused by lung carcinoma were randomly divided into 2 groups： control group （20 cases） and treatment group （24 cases） ; treatment group underwent pleural biopsy of the pri- mary lesions and PPTC under VATS without thoraeotomy. PPTC consists of irrigating the pleural space with 43.0 degrees C saline （3000ml） solution containing eisplatin （300 mg） using a devised eireuiteireular intrapleural hyperthermie perfusion with 42.0 -44.0 degrees C warmed normal saline for 60 minutes. Intrapleura injection of saline solution containing eisplatin （60 - 80mg） was administered in control group, after drainage of pleural effusion. The control rate of pleural effusion, Karnofsky performance status （KPS） grade, side - effects and survival time of the patients were compared. Result Treatment group achieved control rate of 100% , but 60% in control group ,with significant diferenee （P 〈 0.05）. Increasing of Karnofsky performance status （KPS） grade in treatment group were higher than control group （P 〈0.05）. 1 - year survival rate of treatment group and control group were 70.8% and 45% respectively. There were no significant side effect in two groups. Conclusion Pleural perfusion thermo - chemotherapy under VATS is a new, safe, less invasive and more effective approach for for malignant pleural effusion （MPE） caused by lung carcinoma.
出处
《医学研究杂志》
2008年第4期124-125,共2页
Journal of Medical Research
关键词
胸腔镜
肺癌
胸腔积液
热化疗
Video assisted thoracoscopic surgery
Lung carcinoma
Pleural effusion
Thermo- chemotherapy
