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目的:探讨国产红色诺卡菌细胞壁骨架(胞必佳)加顺铂对恶性肿瘤患者胸腔积液的疗效和安全性。方法:68例患者随机分为治疗组36例和对照组32例。治疗组于胸腔积液引流后用胞必佳600μg,顺铂40～60mg,地塞米松10mg,利多卡因10mL,生理氯化钠溶液40mL,胸膜腔内注射,每周1～2次,连续2～6次。对照组除不用胞必佳外外,其他治疗同治疗组。给药后每周查血、尿常规及肝肾、心功能,详细记录胸腔内给药前后的有关症状;给药后3d和2周、4周分别作B超检查。结果:治疗组有效率94.4%,对照组有效率46.9%,治疗组疗效明显优于对照组(P<0.01)。两组药物不良反应均表现为呕吐、胸痛、发热和白细胞减少等,对照组发生率较低,但与治疗组比较无显著差异。结论:胞必佳加顺铂胸腔内注射治疗恶性胸腔积液明显优于单用顺铂组,方法较为简便、安全,适用于临床推广。
Objective: To investigate the curative effect and safety of domestic red cell wall of Lycca (cell-bound) plus cisplatin on pleural effusion in patients with malignant tumors. Methods: Sixty-eight patients were randomly divided into treatment group (36 cases) and control group (32 cases). The treatment group was treated with pleuromucosal 600μg, cisplatin 40 ~ 60mg, dexamethasone 10mg, lidocaine 10mL, physiological sodium chloride solution 40mL, intrapleural injection once or twice a week 2 to 6 times. In addition to the control group without cell must be good, the other treatment with the treatment group. Weekly blood test, urine routine, liver, kidney and heart function were given after administration, and the symptoms before and after intrathoracic administration were recorded in detail. B-mode ultrasound examination was performed at 3d and 2 weeks and 4 weeks after administration. Results: The effective rate was 94.4% in the treatment group and 46.9% in the control group, and the curative effect in the treatment group was obviously better than that in the control group (P <0.01). Two groups of adverse drug reactions showed vomiting, chest pain, fever and leukopenia, the incidence of the control group is lower, but no significant difference compared with the treatment group. Conclusion: Intrapleural injection of Cisplatin and Cisplatin is superior to cisplatin alone in the treatment of malignant pleural effusion. The method is simple, safe and suitable for clinical application.