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目的探讨多西紫杉醇胸腔灌注化学疗法(化疗)治疗恶性胸腔积液的有效性及安全性。方法选取2013年3月-2014年6月经活体组织检查或术后病理确诊为恶性肿瘤且合并胸腔积液患者23例(经胸腔积液脱落细胞学检查均证实为恶性胸腔积液),予胸腔穿刺置管引流,待胸腔积液基本排净后,排除化疗禁忌,给予多西紫杉醇40 mg/m~2+生理盐水250 mL+地塞米松10 mg胸腔内灌注化疗,每21天为1个周期,其中灌注前需行多西紫杉醇用药前标准预处理防治过敏及体液潴留不良反应(地塞米松、西米替丁或雷尼替丁、异丙嗪),每个周期评估疗效及安全性。结果 23例入选患者中,6例患者疗效评价为完全缓解,11例患者疗效评价为部分缓解,有效率达73.91%;患者可耐受,不良反应主要为骨髓抑制(78.26%)及恶心、呕吐(82.61%)。所有患者均未见过敏、体液潴留、心脏毒性不良反应,以及Ⅳ度不良反应。结论多西紫杉醇胸腔灌注化疗治疗恶性胸腔积液疗效确切,不良反应轻,值得临床推广。
Objective To investigate the efficacy and safety of docetaxel thoracic infusion chemotherapy (chemotherapy) in the treatment of malignant pleural effusion. Methods Twenty-three patients (malignant pleural effusion confirmed by pleural effusion cytology) who had been diagnosed as malignant tumor via biopsy or postoperative pathology from March 2013 to June 2014 and were admitted to the thorax Puncture catheter drainage, until the basic drainage of pleural effusion, excluding chemotherapy taboo, given docetaxel 40 mg / m ~ 2 + saline 250 mL + dexamethasone 10 mg intrapleural chemotherapy, every 21 days for a period , Pretreatment of docetaxel before the need for standard pretreatment control allergy and fluid retention adverse reactions (dexamethasone, cimetidine or ranitidine, promethazine), each cycle to assess the efficacy and safety. Results Among the 23 patients selected, the curative effect was evaluated as complete remission in 6 patients and partial response was achieved in 11 patients. The response rate was 73.91%. The patients were tolerant. The main adverse reactions were myelosuppression (78.26%) and nausea and vomiting (82.61%). All patients had no allergies, fluid retention, adverse cardiac toxicity, and grade Ⅳ adverse reactions. Conclusions Docetaxel thoracic infusion chemotherapy for the treatment of malignant pleural effusion is effective and has mild adverse reactions. It is worthy of clinical promotion.