腹腔热化疗治疗恶性腹水的临床观察

目的　观察温热加局部化疗治疗恶性腹水的疗效、生存质量和不良反应。方法　 5 4例恶性腹水病人随机分为两组 ,治疗组和对照组。均置腹腔引流管 ,先予腹腔冲洗 ,后灌注化疗药物PDD 70mg。治疗组冲洗液及溶药液入腹温度为 45℃。对照组冲洗液及溶药液入腹不加温。每周重复 2次 ,2周为 1疗程。结果　近期疗效 :治疗组总有效率 80 %,对照组总有效率 5 4 2 %。远期疗效 :治疗组半年内生存率 3 3 3 %,1年以上生存率 2 6 7%。对照组半年内生存率 66 7%,1年以上生存率 4 2 %。经统计学处理 ,两组近期疗效、远期疗效均有显著差异 (P <0 0 5 )。Karnofsky评分 :治疗组评分升高占 70 0 %( 2 1/3 0 )。对照组评分升高占 5 0 %( 12 /2 4)。经统计学处理 ,两组有显著差异 (P <0 0 5 )。结论　腹腔温热化疗治疗恶性腹水疗效好 ,不良反应少 ,安全性高 ,值得推广。

The Observation of Treatment of Malignant Peritoneum Effusion Using Hyperthermia Combined with Cisplatin Intrapleural Injection

Objective To study the efficacy of therapy combined with Cisplatin intrapleural injection in treatment of malignant peritoneum effusion.Methods 54 cases with malignant peritoneum effusion were randomized into two groups.All the patients were catheterized,drained and flushed,then cisplatin 70 mg.The cases were treated with hyperthermia therapy.Two groups were 1-2 time/week for two weeks,and then recent curative effects and far curative effects,side effects and quality of life was evaluated.Results Recent curative effects:the treatment groups were 80%,the corresponding control groups were 54 2%.Far curative effects:the treatment groug 1/2 year survival rate was 33 3%.1 year survival rate was 26.7%.The corresponding control groups 1/2 year survival rate was 66.7%.1 year survival rate was 4.2%.The Karnofsky score was higher in the treatment groug than that in the corresponding control group.The side effects were tolerable.There was statistical difference between the two groups( P <0 05).Conclusion Hyperthermia therapy combined with Cisplatin intrapleural injection can effectively control malignant peritoneum effusion and improve the quality of life.The side effects were few.There fore,it is warranted for wide use.