肺癌是引起恶性胸水的常见原因。一旦合并胸水也多提示疾病的晚期,此时依赖全身化疗或放疗控制胸水往往疗效不佳,而用药物进行胸膜固定术对此类患者可作为治疗手段。作者将53例经病理证实为肺癌恶性胸水的住院患者随机分为2组,2组患者在年龄、性别、病理组织学类型、一般状况及治疗史方面均无明显差别。一组(26例)采用OK—432,另一组(27例)采用丝裂霉素C作胸膜固定术治疗。治疗前4周及治疗期间不作任何全身化疗或放疗,所有患者既往无青霉素过敏史。具体方法是先行胸腔内插管,留置引流,每周1次向胸膜腔注射10KB的OK—432(1KE的OK—432相当于0.1mg的干燥链球菌)或经蒸馏水30ml稀释的丝裂霉素C8mg,直到胸水消失或经4次注射则拔除导管中止治疗。疗效判断:①完全反应:经临床及CT、胸片或超声证实胸水和症状完全消失4周以上;②部分反应;治疗4周后胸水虽再出现,但胸水 Lung cancer is a common cause of malignant pleural effusion. Once the merger of pleural effusion is also more suggestive of the late stage of the disease, at this time rely on systemic chemotherapy or radiotherapy to control pleural effusion is often poor efficacy, and the use of drugs for pleurodesis can be used as a treatment for such patients. The authors randomized 53 cases of hospitalized patients with malignant pleural effusion confirmed by pathology to two groups. There was no significant difference in age, gender, histopathological type, general condition, and treatment history between the two groups. One group (26 cases) was OK-432, and the other group (27 cases) was treated with mitomycin C for pleurodesis. No systemic chemotherapy or radiotherapy was performed 4 weeks before treatment and during the treatment period. All patients had no prior history of penicillin allergy. The specific method is to advance the intrathoracic intubation, indwelling drainage, once a week to the pleural cavity injection of 10KB of OK-432 (1KE OK-432 equivalent to 0.1mg of dry Streptococcus) or distilled water diluted 30ml of mitomycin C8mg until the pleural effusion disappears or the catheter is discontinued after 4 injections. Efficacy judgment: 1 Complete response: Clinical and CT, chest X-ray or ultrasound confirmed pleural effusion and symptoms completely disappeared for more than 4 weeks; 2 parts of the reaction; after 4 weeks of treatment, pleural effusion reappeared, but pleural effusion