顺铂联合香菇多糖局部治疗肺癌恶性胸腔积液的临床研究

目的：探讨顺铂联合香菇多糖局部胸膜腔内注射治疗肺癌合并恶性胸腔积液的近期疗效及安全性。方法将明确诊断为肺癌合并恶性胸腔积液的80例患者随机分为联合组和非联合组各40例。在尽可能将胸腔积液引流干净后，联合组予香菇多糖注射液2 mg＋顺铂40～60 mg＋地塞米松5 mg＋2％利多卡因5 ml＋生理盐水40 ml胸膜腔内注射；非联合组予顺铂40～60 mg＋地塞米松5 mg＋2％利多卡因5 ml＋生理盐水40 ml胸膜腔内注射。两组均于第1、7日注射2次。治疗4周后比较两组近期疗效、生活质量和不良反应情况。结果80例均顺利配合完成治疗。联合组有效率为78％、控制率为90％、生存质量改善率为78％，明显优于对照组单独采用顺铂的55％、73％、55％（P均＜0.05）。两组患者发热、胸痛、消化道反应及骨髓抑制等不良反应比较差异无统计学意义（P均＞0.05）。结论香菇多糖联合顺铂胸膜腔内注射治疗肺癌合并恶性胸腔积液近期疗效优于单用顺铂治疗，且不增加不良反应发生率。

Treatment of malignant pleural effusion caused by lung cancer via intrapleural injection of cisplatin and lentinan

Objective To explore the short-term curative efficacy and safety in treatment of malig-nant pleural effusion caused by lung cancer via intrapleural injection of cisplatin and lentinan. Methods Eighty patients with lung cancer and malignant pleural effusion were randomly divided into combination group and control group. The combination group received intrapleural injection with cisplatin and lentinan after pleu-ral effusion was drained,and the control group received intrapleural injection with cisplatin only. Both groups received injection twice. Four weeks after treatment,the recent curative effect,life quality and adverse reac-tions were evaluated and compared between two groups. Results All patients successfully completed the treat-ment. The effective rate,control rate and improvement rate of life quality of combination group were better than those of control group （78% vs 55%,90% vs 73%,78% vs 55%,P〈0.05 ）. The incidence of adverse reactions in two groups had no significant difference （P〉0.05 ）. Conclusions Intrapleural injection of lenti-nan plus cisplatin has obvious curative effect in treating malignant pleural effusion caused by lung cancer,with-out incresed toxicity.