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目的观察胸腔内静脉导管留置注入羟基喜树碱治疗恶性胸腔积液的临床效果。方法治疗组采用改良的Seldinger法经皮穿刺,将一次性单腔中心静脉导管置入胸腔并保留,在胸腔积液引流干净后,由导管注入生理盐水30 mL加羟基喜树碱10 mg及生理盐水10 mL加地塞米松10 mg,夹管24 h后再引流,无积液引出后再注入上述药物,夹管保留24 h,一般注药2~5次,48 h无积液引出则可拔管;同时服用葶苈大枣泻肺汤合五苓散加减。对照组常规胸腔穿刺,每次抽胸水800~1 000 mL,然后将DDP 60 mg加生理盐水40 mL和利多卡因10 mL、地塞米松10 mg注入胸腔内,每周1次,2周为1个疗程。结果治疗组有效率(88%)明显高于对照组(P<0.05)。结论胸腔内静脉导管留置注入羟基喜树碱治疗恶性胸腔积液疗效好,具有创伤小、操作简单、患者痛苦少及不良反应少等优点。
Objective To observe the clinical effect of intrathoracic venous catheter indwelling hydroxycamptothecin in the treatment of malignant pleural effusion. Methods The modified Seldinger method was used in the treatment group. One-time single-lumen central venous catheters were placed in the thoracic cavity and retained. After the pleural effusion was drained, 30 mL of normal saline and 10 mg of hydroxycamptothecin plus 10 mg of physiologically Saline 10 mL plus dexamethasone 10 mg, re-drainage after 24 h of pinching, no effusion leads to injection of the above drugs, pinch retention 24 h, the general injection of 2 to 5 times, 48 h without effusion leads to pull Tube; taking 葶 苈 Jujube diarrhea soup combined with Wulingsan addition and subtraction. Control group, conventional thoracentesis, each time pleural effusion 800 ~ 1 000 mL, and then DDP 60 mg plus saline 40 mL and lidocaine 10 mL, dexamethasone 10 mg into the chest once a week for 2 weeks 1 course of treatment. Results The effective rate (88%) in the treatment group was significantly higher than that in the control group (P <0.05). Conclusion Intrathoracic venous catheter infusion of hydroxycamptothecin for the treatment of malignant pleural effusion has good curative effect, with less trauma, simple operation, less pain and fewer adverse reactions.