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目的 评价博莱霉素、顺铂在治疗癌性胸腔积液中的优劣。方法 自 1996年 9月至 1999年 4月 ,随机采用博莱霉素与顺铂进行胸腔内注射 ,治疗癌性胸腔积液 85例 ,观察二种药物的疗效、胸膜反应及毒副作用。结果 博莱霉素组 41例 ,有效率 73 .2 % ( 3 0 /4 1)。顺铂组 44例 ,有效率 72 .7% ( 3 2 /4 4 ) ,P >0 .0 5。所有有效病例均有胸膜增厚 ,二组胸膜增厚程度无明显差别 ,P >0 .0 5。毒副作用 :博莱霉素组消化道反应发生率低于顺铂组 ,分别为 2 2 .0 %、5 0 .0 % ,P <0 .0 1。骨髓抑制、胸痛的发生率二组相似 ,程度轻微。未见由药物引起的发热、肝肾功能异常、肺纤维化改变。结论 二药疗效均满意 ,毒副反应不大 ,因使用博莱霉素无需水化 ,故更适用于晚期及体弱、心肺功能差者。
Objective To evaluate the advantages and disadvantages of bleomycin and cisplatin in the treatment of cancerous pleural effusions. Methods From September 1996 to April 1999, bleomycin and cisplatin were randomly used for intrapleural injection to treat 85 cases of cancerous pleural effusion. The efficacy, pleural reaction and side effects of the two drugs were observed. Results There were 41 patients in the bleomycin group with an effective rate of 73.2% ( 3 0 /41). There were 44 patients in the cisplatin group with an effective rate of 72.7% (32/4 4) and P > 0.05. All effective cases had pleural thickening, and there was no significant difference in pleural thickening between the two groups (P > 0.05). Side effects: The incidence of gastrointestinal reactions in the bleomycin group was lower than that in the cisplatin group, which was 22.0%, 5.00%, P<0.01. The incidence of myelosuppression and chest pain was similar in the two groups with slight degree. No drug-induced fever, abnormal liver and kidney function, and pulmonary fibrosis were observed. Conclusion The efficacy of the two drugs are satisfactory, and the toxic and side effects are not significant. The use of bleomycin does not require hydration, so it is more suitable for patients with advanced and weak body and poor cardiopulmonary function.