经导管持续闭式引流联合大剂量IL-2和顺铂治疗肺癌恶性胸腔积液疗效观察

目的观察胸腔内注入白细胞介素-2联合顺铂（PDD）治疗肺癌恶性胸腔积液的近期疗效和毒副反应。方法45例肺癌伴恶性胸腔积液患者，先用美国FORNIT公司生产的一次性双腔中心静脉导管进行胸腔置管和闭式引流胸水。后给予胸腔内注药，A组（n=24例）胸腔灌注白细胞介素-2联合顺铂；B组（n=21例）胸腔灌注单用顺铂。白细胞介素-2每次注入400万u，顺铂每次注入60mg，每周注射1次，连续注射3周，1个月后观察两组的疗效及不良反应。结果白细胞介素-2联合顺铂对恶性胸腔积液的有效率为83．3％，明显优于单用顺铂组52．5％（P〈0．05），毒副反应无显著性差异。结论胸腔置管引流并灌注白细胞介素-2联合顺铂治疗肺癌恶性胸腔积液，疗效肯定，是控制恶性胸腔积液的有效疗法。

Intracatheter injection of high-dose IL-2 and PDD in the treatment of lung cancer combining malignant pleural effusion

Objective To evaluate the effect and side-effects of IL-2 and PDD in the treatment of the patients with lung cancer combining malignant pleural effusion by intracatheter injection. Methods 45 patients with lung cancer combining malignant pleural effusion were applied with the double cavity central venous catheters made by FORNIT Company in USA. All patients were taken the closed thoracic drainage and divided into two groups. The patients in the research group A （ n = 24 ） were treated by intracavity injection of IL-2 and PDD, and those in the control group B （n =21 ） were treated by intracavity injection of PDD only. IL-2 at a dose of 4 × 10^6u every time was injected intrapleurally and that of PDD was 60 mg every time. The above dose was given one time every 7 days for 3 weeks. The therapeutic effect and adverse reactions were observed after one month. Results The effective rate of 83.3% in the research group A was higher than that of 52.5 % in the control group B （ P 〈 0. 05 ）, there was no obvious difference of toxicity between the two groups. Conclusion After draining completely the pleural effusion, the intracavity injection of IL-2 and PDD is more effective for the treatment of malignant pleural effusion.