微创置管胸腔内注射顺铂及香菇多糖治疗恶性胸腔积液

目的：总结微创置管引流、胸腔内注射顺铂及香菇多糖治疗恶性胸腔积液的疗效。方法：70例患者按顺序分为治疗组（35例）和对照组（35例），均采取留置中心静脉导管穿刺引流，治疗组胸腔内注射顺铂及香菇多糖，对照组注射顺铂。结果：治疗组、对照组有效率分别为88．6％、54．3％（P〈0．05），治疗组胸水中CEA、CYFRA21—1、NSE浓度较治疗前明显下降，较对照组明显降低（P〈0．05），外周血NK细胞活性，T淋巴细胞中的CD3^＋、CD4^＋及CD4^＋／CD8^＋比值明显增高（P〈0．05）。结论：微创置管引流、胸腔内注射顺铂及香菇多糖治疗恶性胸腔积液安全有效，具有创伤小、操作简便、痛苦少、对年老体弱患者也适用等特点.

Treatment of Malignant Pleural Effusion by Minitraumatic Tube Installation with Intrapleural Injection Cisplatin and Lentinan

Objective To summarize the effect of treatment for the patients with malignant pleural effusion by mini- traumatic tube installation with intrapleural injection of cisplatin and lentinan. Methods Seventy patients with malignant pleural effusion were randomly divided into therapeutic group and control group. Intrapleural injection of cisplatin and lentinan were administered in the therapeutic group, but only cisplatin was given in the control group. The effect on malignant pleural effusion, the changes on the concentration of CEA, CYFRA21 - 1, NSE, the immune indices （such as NK cell, CD3^＋ cell. CD4^＋ cell）, the quality of patients＇ （QOS） life and the side effects were observed and compared before and after the treatment. Results The therapeutic group achieved total response rate of 88.6 %, but only 54.3 % in the control group, with significant difference（ P 〈 0.05）. The concentration of CEA, CYFRA21 - 1, NSE in the therapeutic group dramatically descended lower than in the control group（ P 〈 0.01 ）. furthermore, NK cell, CD3^＋ cell, CD4^＋ cell, CD4^＋/CD8^＋ in the therapeutic group was dramatically higher than in the control group（ P 〈 0.05）. But there was no significant difference in side effects（ P 〈 0.05）. Conclusion Treatment of malignant pleural effusion by minitraumaic tube installation with intrapleural injection of cisplatin and lentinan is safe and effective, and offers the superiority of small wound, simple procedure and painlessness. It is easily accepted for the aged and weak patients, and also improves the quality of patients＇ （QOS） life.