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目的探讨肺癌合并胸水的综合治疗方法。方法 :对 5 6例肺癌合并胸水患者施行胸膜全肺切除并于开胸前静推顺铂 6 0～ 80mg和环鳞酰胺 80 0～ 10 0 0mg ,术毕关胸前用 4 3～ 4 5℃的蒸馏水浸泡胸腔 30～ 4 5min ,然后用含抗癌药物的生理盐水反复冲洗 ,术后 3d每日静点鬼臼乙叉甙 10 0mg。 1月后开始化疗或放疗。结果 :全组病人术后均控制了胸水和呼吸道症状 ,手术并发症 6例 ,无手术死亡。 1,2 ,3年生存率分别为 89.3% ,5 8.3% ,2 4 .4 %。结论 :胸膜全肺切除配合围手术期化疗和热疗能有效地控制肺癌合并胸水的临床症状 ,减少局部复发 ,延长患者生命。但对预防远期转移尚不满意。
Objective To investigate the comprehensive treatment of lung cancer with pleural effusion. Methods: Fifty-six patients with lung cancer complicated with pleural effusion underwent pleural pneumonectomy and 60-80 mg of cisplatin and 80 0-1000 mg of cyclosporine were given before the thoracotomy. ℃ distilled water soaked in the thorax 30 ~ 45min, and then repeatedly rinsed with saline containing anticancer drugs, intravenous daily intravenous etoposide 100mg after 3d. After January chemotherapy or radiotherapy. Results: All the patients underwent control of pleural effusion and respiratory symptoms after operation. There were 6 cases of surgical complications without any surgical death. The 1, 2, 3-year survival rates were 89.3%, 53.3%, 24.4% respectively. Conclusion: Pleural pneumonectomy combined with perioperative chemotherapy and hyperthermia can effectively control the clinical symptoms of lung cancer combined with pleural effusion, reduce local recurrence and prolong the life of patients. However, they are not satisfied with the prevention of long-term transfer.