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目的观察原发性肺癌导致的恶性胸腔积液分别用洛铂与顺铂胸腔灌注治疗疗效及药物毒副反应差别。方法选择2013年8月—2016年8月通过胸水细胞学或病理学确诊的原发性肺癌导致的恶性胸腔积液患者52例,共分成二组,观察组25例胸腔注射洛铂30~50mg,对照组27例胸腔注射顺铂,50~80mg/次。结果观察组25例治疗后评价完全缓解6例(24.0%),部分缓解13例(52.0%),未缓解6例(24.0%),总有效率76.0%。对照组27例治疗后评价完全缓解6例(22.2%),部分缓解12例(44.4%),未缓解9例(33.3%),总有效率66.6%。差异无统计学意义(χ~2=0.4628,P>0.05)。治疗后KPS评分二组均有提高,二组患者生活质量改善观察组较对照组更明显,差异有统计学意义(χ~2=4.6235,P<0.05)。二组患者治疗过程中发生的毒副作用以血小板减少、白细胞减少发生风险高,但二组比较差异无统计学意义(P>0.05)。在乏力、恶心、呕吐发生率上二组差异有统计学意义(P<0.05)。结论对原发性肺癌导致的恶性胸腔积液,在充分胸腔引流的基础上采用洛铂胸腔灌注化疗,疗效肯定,毒副作用轻微,值得临床推广应用。
Objective To observe the efficacy and drug toxicity of lobaplatin and cisplatin in the treatment of malignant pleural effusion caused by primary lung cancer. Methods From August 2013 to August 2016, 52 patients with malignant pleural effusion caused by primary lung cancer diagnosed by pleural fluid cytology or pathology were divided into two groups. In the observation group, 25 patients received lobaplatin 30 ~ 50mg , 27 cases of control group, intrapleural injection of cisplatin, 50 ~ 80mg / time. Results In the observation group, 6 cases (24.0%) were completely relieved after treatment, 13 cases (52.0%) partially relieved, 6 cases (24.0%) did not relieve, and the total effective rate was 76.0%. In the control group, 6 cases (22.2%) were completely relieved after treatment, 12 cases (44.4%) partially relieved, 9 cases (33.3%) did not relieve, and the total effective rate was 66.6%. The difference was not statistically significant (χ ~ 2 = 0.4628, P> 0.05). After treatment, the KPS scores increased in both groups, and the quality of life improvement in the two groups was more obvious than that in the control group (χ ~ 2 = 4.6235, P <0.05). The two groups of patients with toxic and side effects occurred during thrombocytopenia, leukopenia risk, but there was no significant difference between the two groups (P> 0.05). There was significant difference between the two groups in the incidence of fatigue, nausea and vomiting (P <0.05). Conclusion For malignant pleural effusion caused by primary lung cancer, lobaplatin and thoracic perfusion chemotherapy based on sufficient chest drainage have certain curative effect and slight toxic and side effects, which is worthy of clinical application.