局部热疗联合药物灌注治疗恶性胸腔积液疗效观察

目的探讨局部热疗联合药物治疗恶性胸腔积液的临床疗效及其对患者生活质量的影响。方法恶性胸腔积液患者94例,行胸腔穿刺置入中心静脉导管彻底引流排尽积液后分为A、B2组接受后续治疗。A组（45例）采用药物治疗后予患侧胸腔局部热疗,温度42.5～42.8℃、时间1h,热疗每72小时重复1次。B组（49例）只给予药物治疗及治疗后翻身。结果2组间疗效比较差异有统计学意义（u=3.96,P〈0.01）。2组生存质量间差异有统计学意义（u=2.74,P〈0.01）。结论热疗作为一种杀灭肿瘤细胞的有效方法,与药物联合治疗恶性胸腔积液可明显改善患者的临床症状及生活质量,不良反应可以耐受,值得推广应用。

Therapeutic effect of local hyperthermia combined with intrathoracic injection on malignant pleural effusion

Objective To observe the therapeutic effect of local hyperthermia combined with intrathoracic injection on malignant pleural effusion and the influence on the life quality of patients with malignant pleural effusion. Methods Ninety-four patients with malignant pleural effusion were treated by inserting central venous catheters into thoracic cavity,and their malignant pleural effusion was extracted completely,and all the patients were randomly divided into group A and group B. The 45 patients in group A were treated with the combonation of local high-frequency hyperthermia and intrapleural infusion,including cisplatinum 60mg,bleomycin 45mg,lentinan 4 mg,or IL-2 200 million units. The patients＇bodies were turned over beyond an hour after thoracic injection,then the patients received local high-frequency hyperthermia. The local hyperthermia was performed in the next day when the lentinan or IL-2 was injected into the thoracic cavity. The hyperthermia therapy time lasted for 90 minutes,and the temperature of local body maintained at 42.5-42.8℃. Hyperthermia was repeated every 72 hours. According to the amount of pleural effusion the therapies mentioned above were repeated every 5 to 7 days. The 49 patients in group B were treated only by thoracic injection and turning the body over beyond an hour. Results There was a significant difference in the therapeutic effect between the two groups（P〈0.01）,and There was a significant difference in patients＇life quality between two groups（P〈0.01）. Conclusion Hyperthermia is an effective way to kill tumor cells,especially,local hyperthermia combined with intrathoracic injection can obviously improve the patients＇clinical symptoms and life quality,with few side effects,so the therapy is worthy of be widely used in the treatment of malignant pleural effusion.