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目的 探讨支气管动脉灌注化疗加免疫治疗肺癌伴恶性胸水的价值。方法 将 75例肺癌伴恶性胸水患者随机分为两组 :试验组 38例 ,胸穿抽净胸水后向胸腔内注入化疗药物 (胸腔内化疗 ) ,再行支气管动脉灌注化疗加免疫治疗 ;对照组 37例 ,仅行胸腔内化疗。比较两组病例第 1疗程的疗效 (治疗肺癌疗效和控制胸水效果 )及 1、2年生存率。结果 第 1疗程治疗后 ,试验组治疗肺癌的总有效率为 31.5 8% ( 12 /38) ,对照组为 5 .41% ( 2 /37) ,两组间比较差异非常显著 ( χ2 =8.46 ,P <0 .0 1) ;试验组控制胸水的有效率为86 .84% ( 33/38) ,对照组为 6 4.86 % ( 2 4/37) ,两组间比较有显著性差异 ( χ2 =4.96 ,P <0 .0 5 )。试验组患者1、2年生存率分别为 6 5 .79% ( 2 5 /38)和 2 6 .32 % ( 10 /38) ,对照组为 40 .5 4% ( 15 /37)和 5 .41% ( 2 /37) ,前者明显高于后者 ( χ2 =4.80 ,P <0 .0 5 ;χ2 =6 .10 ,P <0 .0 5 )。结论 胸腔内化疗联合支气管动脉灌注化疗加免疫治疗肺癌伴恶性胸水 ,是一种有价值的治疗方法
Objective To investigate the value of bronchial artery infusion chemotherapy combined with immunotherapy for lung cancer with malignant pleural effusion. Methods Thirty-five patients with malignant pleural effusion and lung cancer were randomly divided into two groups: the experimental group (38 cases), the thoracic cavity after thoracentesis, the chemotherapy drugs (intrathoracic chemotherapy), the bronchial artery infusion chemotherapy plus immunotherapy, the control group 37 cases, only intrathoracic chemotherapy. The curative effect of the first course of treatment was compared between two groups (the curative effect of treating lung cancer and the effect of controlling pleural effusion) and the one and two year survival rate. Results After the first course of treatment, the total effective rate of the treatment group was 31.5 8% (12/38) and that of the control group was 5 .41% (2/37), the difference between the two groups was significant (χ2 = 8.46, P <0.01). The effective rate of control pleural effusion in experimental group was 86.84% (33/38) and that in control group was 4.86% (24/37), there was significant difference between the two groups (χ2 = 4.96, P <0.05). The 1-year and 2-year survival rates were 65.7% (2/38) and 26.32% (10/38) in the test group and 40.5% (15/37) and 5% in the control group, respectively. 41% (2/37), the former was significantly higher than the latter (χ2 = 4.80, P <0.05; χ2 = 6.10, P <0.05). Conclusions Thoracic chemotherapy combined with bronchial arterial infusion chemotherapy and immunotherapy of lung cancer with malignant pleural effusion is a valuable treatment