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目的评价热灌注治疗加局部化疗治疗肺癌胸腔积液的综合疗效,并讨论其机制。方法采用循环胸腔43℃生理盐水加顺铂治疗25例肺癌胸腔积液患者,随访观察胸水疗效、不良反应、实验室检查等,评价综合疗效。并同以往单用顺铂组治疗对比。结果热疗+化疗治疗胸腔积液有效率达96%,对照组仅31%。结论热灌注疗法加局部化疗为治疗肺癌胸腔积液的有效新方法。机制为温热使顺铂对耐药细胞毒性恢复并具增敏作用,凋亡介导的癌细胞热杀伤作用,热疗后机体免疫功能增强和灌洗液的物理冲刷作用是重要机制。
Objective To evaluate the combined effect of hyperthermic perfusion and local chemotherapy in the treatment of lung cancer pleural effusion and to discuss its mechanism. Methods Twenty-five patients with pleural effusion of lung cancer were treated with cyclothoracic 43 ℃ saline and cisplatin. The pleural effusion efficacy, adverse reactions, laboratory tests were followed up to evaluate the comprehensive effect. And with the previous single cisplatin treatment comparison. Results Hyperthermia + chemotherapy for pleural effusion efficiency of 96%, control group, only 31%. Conclusion Hot perfusion therapy combined with local chemotherapy for the treatment of pleural effusion in lung new effective method. Mechanism of warm to cisplatin on drug-resistant cell toxicity and sensitization, apoptosis-mediated heat cytotoxicity of the cells, hyperthermia immune function enhancement and the physical scouring effect of lavage fluid is an important mechanism.