目的观察亚砷酸胸腔内灌注联合体外高频热疗对癌性胸水患者生活质量的影响。方法连续纳入45例癌性胸水病例,采用抽签法分为A、B、C组。所有患者均尽量引流胸水(至引流量小于150ml/d),A组(15例)经导管向胸腔内灌注亚砷酸20mg,拔除导管并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次;B组(16例)仅予胸腔内灌注亚砷酸20mg并拔除导管;C组(14例)于胸水引净后拔除导管,并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次。在拔管4周后复查胸水量,观察3种治疗方法对癌性胸水的疗效;治疗前后采用FLIC量表记录生活质量积分,并同时记录身体功能状况(KPS)评分变化情况。结果治疗后A、B、C组有效率分别为86.7%、62.5%和50.0%;A组胸水疗效优于B组和C组(P<0.05)。A组在躯体良好和能力、总量表领域与治疗前比较有显著性差异(P<0.05);在因癌造成的艰难领域,与治疗前比较有显著性差异(P<0.01)。3组的KPS评分均较各自治疗前提高(P<0.01),以A组的KPS评分升高最为明显。结论亚砷酸胸腔内灌注联合体外高频热疗控制癌性胸水能改善患者的生活质量,提高身体功能状况评分,对提高疗效和改善预后有一定的积极意义。 Objective To observe the effect of intrapleural perfusion of arsenious acid combined with high frequency hyperthermia in vitro on the quality of life of patients with cancerous pleural effusion. Methods A total of 45 cases of cancerous pleural effusion were included in the study. The patients were divided into groups A, B and C by random selection. All patients were treated with drainage of pleural effusion (to less than 150ml / d). In group A (15 cases), 20mg of arsenious acid was infused through the catheter into the thoracic cavity. The catheter was removed and local thoracic hyperthermia was performed on the same day. Once a day for 4 times. In group B, only 20 mg of arsenious acid was infused into the thoracic cavity and the catheter was removed. In group C, 14 patients were removed after removal of the pleural effusion and were treated with thoracic local hyperthermia once a day , After the next day hyperthermia 1, 4 consecutive times. After 4 weeks of extubation, the amount of pleural fluid was reviewed, and the curative effect of the three treatments on cancerous pleural effusion was observed. Before and after treatment, the quality of life score was recorded by FLIC scale and KPS scores were also recorded. Results After treatment, the effective rates of A, B and C groups were 86.7%, 62.5% and 50.0% respectively. The efficacy of pleural effusion in group A was better than that in group B and C (P <0.05). There was a significant difference (P <0.05) between group A and group B in physical fitness and ability. There was a significant difference (P <0.01) in the difficult area caused by cancer compared with that before treatment. The KPS scores of three groups were significantly higher than those before treatment (P <0.01), and the KPS scores of group A were the most obvious. Conclusion Intrathoracic perfusion of arsenious acid combined with high frequency hyperthermia in vitro can improve the quality of life of patients and improve the functional status of the patients, which has a positive effect on improving the curative effect and improving the prognosis.