摘要
目的探讨应用中央静脉导管进行胸腔闭式引流的临床价值，并观察博来霉素、顺铂治疗恶性胸腔积液的疗效。方法46例肺癌伴恶性胸腔积液患者随机分为2组，2组患者均经皮胸腔穿刺，钢丝引导置入中心静脉导管并固定，加一次性使用输液器作延长管，接水封瓶行闭式引流。博来霉素组（n=23）予胸腔注射博来霉素40～60mg／次、顺铂组（n=23）予胸腔注射顺铂60～80mg／次，共3次，每次间隔1周。结果所有病例均引流满意，置管期间局部未出现不适，无并发症发生；博来霉素组、顺铂组总有效率差异无显著性（78．2％vs．73．9％，P〉0．05）。顺铂组2例患者出现骨髓抑制，但博来霉素组、顺铂组间总毒副反应发生率差异无显著性（30．4％vs．34．7％，P〉0．05）。结论中心静脉导管行胸腔闭式引流术操作简单，创伤小，无痛苦，带管活动方便，引流效果满意。博来霉素与顺铂局部应用对恶性胸腔积液均有良好疗效，使用顺铂时要注意骨髓抑制。
Objective To discuss the clinical value of closed drainage of pleural cavity with central venous catheter and to evaluate the effect and adverse reactions of bleomycin and cis - diaminodichloroplatin in the treatment of the patients with pulmonary neoplasm combined with malignant pleural effusion by thoracic cavity perfusion drainage. Methods 46 patients with pulmonary neoplasm combined with malignant pleural effusion were randomly divided into two groups. After percutaneous puncture, each patient was embedded with a central venous catheter by a guide wire, with a disposable infusion set as the extension tube, which was connected to a water - sealed drainage bottle for closed drainage. In group A （ n = 23 ）, injection of bleomycin 40 - 60 mg and in group B （ n = 23 ）, injection of cis - diaminodichloroplatin 60 - 80 mg were given intrapleurally. The procedures were performed at an interval of a week for three times. Results The effectiveness of treatment in both groups was satisfactory. No local discomfort or complications occurred. The total efficiencies in bleomycin and cis - diaminodichloropl groups were 78.2% and 73.9%, respectively; the difference was considered insignificant （ P 〉 0.05 ）. 2 patients in cis - diaminodichloroplatin group were found to have inhibition of bone marrow, but there was no marked difference in the incidence of side effects between bleomycin group and cis - diaminodichloroplatin group （30.4% vs. 34.7%, P 〉 0.05）. Conclusion The closed drainage of pleural cavity with central venous catheter is easy to manipulate, with minor trauma, no complaints, convenience in patient activity and satisfactory drainage effect. Bleomycin and cis - diaminodichloroplatin were effective and safe on patients with pulmonary neoplasm combined with malignant pleural effusion, but precautions should be taken to prevent inhibition of bone marrow.
出处
《徐州医学院学报》
CAS
2008年第11期719-721,共3页
Acta Academiae Medicinae Xuzhou
关键词
肺肿瘤
胸腔积液
中心静脉导管
顺铂
博莱霉素
lung neoplasms
pleural effusion
central venous catheter
cis- diaminodichloroplatin
bleomycin
