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目的探讨闭式肠腔引流联合洛铂胸腔内灌注化疗治疗恶性胸腔积液的疗效及药物毒副作用。方法 30例通过胸腔细胞学或病理学确诊的恶性胸腔积液患者,肺癌17例,乳腺癌10例,恶性间皮瘤2例,胰腺癌1例。采用留置导管胸腔闭式引流,待引流结束后将洛铂50mg溶于5%葡萄糖注射液50ml中经导管注入胸腔,2周内给药1～3次。观察毒副作用,化疗结束后4周判定疗效。结果 30例患者共胸腔内灌注化疗49次,每例1～3次。治疗1次者14例,2次者13例,3次者3例。治疗后评价完全缓解10例(33.3%),部分缓解16例(53.3%),未缓解4例(13.3%),总有效率86.7%。毒副作用小,均为Ⅰ～Ⅱ度。结论对原发肿瘤来自不同系统的恶性胸腔积液,在充分胸腔引流的基础上采用洛铂胸腔灌注化疗治疗,疗效肯定,毒副反应轻微。
Objective To investigate the curative effect and drug toxicity of closed intestine drainage and lobaplatin chemotherapy for malignant pleural effusion. Methods Thirty cases of malignant pleural effusion diagnosed by thoracocytology or pathology were diagnosed as lung cancer in 17 cases, breast cancer in 10 cases, malignant mesothelioma in 2 cases and pancreatic cancer in 1 case. Indwelling catheter thoracic closed drainage, until the end of drainage after lobaplatin 50mg dissolved in 5% glucose injection 50ml by catheter into the chest, administered within 1 to 3 times. Observation of toxic and side effects, 4 weeks after chemotherapy to determine the efficacy. Results A total of 30 patients received intrathoracic chemotherapy in 49 cases, 1 to 3 times in each case. 14 cases were treated once, 13 cases twice, and 3 cases three times. After treatment, 10 cases (33.3%) were completely relieved, 16 cases (53.3%) partially relieved, 4 (13.3%) unresponsive, and the total effective rate was 86.7%. Small side effects, are Ⅰ ~ Ⅱ degrees. Conclusion The primary tumor from malignant pleural effusion of different systems, the full chest drainage on the basis of lobaplatin intrapleural chemotherapy, positive effect, minor toxicities.