胸腔内置管引流、双路化疗治疗恶性胸水30例

目的观察深静脉穿刺导管胸腔内置管引流、胸腔及静脉双路化疗治疗恶性胸水的疗效，方法将89例恶性胸水患者随机分为3组，Ⅰ组30例予以胸腔置管持续引流，然后胸腔内注射顺铂（DDP）、胞必佳（N。CNS），Ⅱ组30例在Ⅰ组治疗基础上同时静脉给予环磷酰胺（CTX）、阿霉素（ADM）治疗，Ⅲ组29例常规抽胸水然后胸腔内注射DDP。结果Ⅰ、Ⅱ、Ⅲ组总有效率分别为86．6％、93．3％、37．9％，Ⅰ组与Ⅱ组比较差异无显著性意义（P〉0．05），Ⅰ组与Ⅲ组、Ⅱ组与Ⅲ组相比差异均有显著性（P〈O．01）。同时观察到Ⅱ组患者肺内病灶均有不同程度缩小。结论深静脉穿刺导管胸腔内置管引流、胸腔及静脉双路化疗是治疗恶性胸水的有效方法。

Treatment of Malignant Hydrothorax with Indwelling Central Venous Catheters into Thoracic Cavity for Continuous Drainage,and with Both Intrathoracic Cavity and Intravenous Chemotherapy

Objective To observe the efficacy of continuous drainage with central venous catheters,both intrathoracic cavity and intravenous chemotherapy in treatment of malignant hydrothorax.Methods Eightynine cases of malignant hydrothorax were divided into three group randomly: group 1 of 30 cases treated with continuous drainage with central venous catheters and intrathoracic cavity chemotherapy(cisplatin,DDP and nocardia rubra cell wall skeleton,N-CWS);group 2 of 30 cases treated as in group 1,but plus intravenous chemotherapy(cyclophosphamide,CTX and doxorubicin,ADM);group 3 of 29 cases treated with traditional drainage and intrathoracic cavity chemotherapy(cisplatin,DDP).Results The total efficiencies of all three groups were 86.6%,93.3%,37.9% respectively.There was no distinct difference between the first two groups(P>0.05) while obvious differences existed between group 1 and group 3 and between group 2 and group 3(P<0.01).Meanwhile,the focuses in lungs of patients in group 2 were noticed to turn smaller at different degrees.Conclusion Indwelling central venous catheters into thoracic cavity for continuous drainage,and both intrathoracic cavity and intravenous chemotherapy are an effective method for treatment of malignant hydrothorax.