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目的 探讨胸腔内注入顺铂 (DDP)联合长春地辛 (VDS)治疗恶性胸腔积液的疗效。方法 病理确诊的恶性胸腔积液 6 0例 ,经胸腔插管引流术排尽胸液后 ,按随机化原则分为 2组 ,治疗组(32例 )在胸腔内注入DDP 40mg/m2 ,VDS 4mg ,对照组 (2 8例 )在胸腔内注入DDP 40mg/m2 ,1周后重复 1次 ,观察疗效、生活质量、生存率以及毒副反应。结果 治疗组总有效率 81% ,病变进展率 3% ,较对照组 5 0 % ,2 5 %差异有显著性 (P <0 0 5 )。Karnofsky评分大于 70分治疗组较对照组有显著提高(P <0 0 5 )。治疗组 0 5年、1年、1 5年、2年的生存率为 97%、5 9%、44 %、6 % ,分别高于对照组的71%、5 0 %、14%、4% ,其中 0 5 ,1 5年的生存率差异有显著性 (P <0 0 5 )。治疗组Ⅰ度白细胞下降较对照组明显。结论 胸腔内联合注入DDP和VDS治疗恶性胸腔积液是一种有效的、副反应小、可耐受的方法
Objective To investigate the efficacy of intrapleural cisplatin (DDP) combined with vindesine (VDS) in the treatment of malignant pleural effusion. Methods Sixty cases of malignant pleural effusions were diagnosed by pathology. After thoracic fluid was drained by thoracic cavity catheterization, they were divided into two groups according to the principle of randomization. The treatment group (32 cases) was injected with DDP 40 mg/m2 in the thoracic cavity. VDS 4 mg In the control group (28 cases), 40 mg/m2 of DDP was injected into the thoracic cavity and repeated one week later. The efficacy, quality of life, survival rate, and adverse reactions were observed. Results The total effective rate of the treatment group was 81%, and the disease progression rate was 3%. Compared with the control group, 50% and 25%, the difference was significant (P < 0.05). Karnofsky score greater than 70 points in the treatment group was significantly higher than the control group (P <0 05). The survival rates of the treatment group at 0 5 years, 1 year, 15 years, and 2 years were 97%, 59%, 44%, and 6%, which were higher than those of the control group by 71%, 50%, 14%, and 4%, respectively. There was a significant difference in survival rate between 0 5 and 15 years (P <0 05). The degree of white blood cells in the treatment group was significantly lower than that in the control group. Conclusion Intrapleural injection of DDP and VDS for the treatment of malignant pleural effusion is an effective method with low side effects and tolerability.