一次性胸腔注入博莱霉素治疗肺癌性胸腔积液的疗效再评价

目的　探讨博莱霉素胸腔注入治疗癌性胸腔积液的疗效。方法　确诊的肺癌性胸腔积液 4 8例 ,胸腔置入中央静脉导管排尽胸液 ,随机分为 2组 ,治疗组 (30例 ) ,胸腔注入博莱霉素 4 5 mg,6小时后放开引流管 ,再次排尽胸液后拔管 ,对照组胸腔注入顺铂 (DDP) 4 0 mg,白介素 - 2 (IL - 2 ) ,1.0× 10 6 U ,1周后再次排尽胸液 ,重复注药 1次后拔管 ,观察 2组疗效、0 .5与 1年生存率及毒副反应。结果　治疗组总有效率 86 .7% ,较对照组的 5 5 .5 %差异有显著性 (P<0 .0 5 )。治疗组 0 .5及 1年生存率分别为 96 .6 %、73% ,分别高于对照组的 88.8%、5 0 %。其一年生存率有显著差异 (P<0 .0 5 )。结论　一次性胸腔注入博莱霉素治疗肺癌性胸腔积液是一种简便、有效和较为安全的方法 ,可推荐作为一线治疗。

Re-evaluation on the clinical effects of using one-time bleomysin intrathorasic injection in the treatment of malignant pleural effusion

Objective To explore clinical effects of using bleimysin intrathosasic injection on malignant pleural effusion.Methods A total of 48 confirmed maglinant pleural effusion patients were randomly divided into two groups: the treatment group (n=30) and the control group (n= 18). All patients were inserted with a central venous tube to empty pleural effusion.. For the treatment group, the bleimysin of 45mg was injected into the patients' intrathorasic. The tube was open six hours later and emptied before it was taken out. For the controls, DDP (40mg) and IL-2 (1.0X10 6U) were injected into the intrathorasic. The pleural effusion was emptied one week later and the tube was taken out after a one-time repeated insertion of the medicine. The two groups were compared in the survival rates of six months, 12 months and the side effects. Results The efficiency rates were 86.7% and 55.5%, respectively for the treatment and control groups: p < 0.01. The survival rates of six months and 12 months were 96.6% and 73% for the treatment group respectively, and were 88.8% and 50% for the controls, respectively. There was a significant difference (P<0.05) between the two groups in the 12-month survival rate.Conclusion One time intrathorasic injection of bleomysin is a simple, effective and safe method, which should be recommended as the first-choice of the treating malignant pleural effusion.