顺铂联用胸腺肽和艾迪注射液治疗恶性胸腔积液的临床观察

目的：探讨顺铂联用胸腺肽和艾迪注射液在治疗恶性胸腔积液中的疗效。方法：选择我院2003年1月-2007年6月老年内科住院大量恶性胸腔积液患者95例．随机分成试验组和对照组，对照组45例，艾迪注注射液50ml加入0．9％生理盐水250ml中，静脉滴注，每天1次15天为1疗程，用顺铂40-60mg，地塞米松10mg，利多卡因100mg，加入0．9％生理盐水40ml经非流管依次注入胸腔内夹管48小时，缓慢引流，每周1次用14次，试验组50例在此基础上胸腔内注入胸腺肽50mg；观察症状、体征、不良反应、生活质量、血常规、肝肾功、心电图等，治疗结束后6周评定疗效。结果：试验组：完全缓解15例，部分缓解28例，总有效率为86％；对照组：完全缓解9例，部分缓解16例，总有效率为55．5％，P〈0．05；生活质量：试验组好转32例，占64％，对照组好转21例，占46．7％，P〈0．05，具有统计学意义。两组均出现发热、恶心、呕吐、纳差、WBC、PLT下降、肝肾功异常等不良反应，P〉0．05，差异无显著性。结论：顺铂联用胸腺肽和艾迪注射液治疗恶性胸腔积液安全有效，不良反应轻微。

Clinical observation of cisplatin cimbined with xiongxiantai and aidi injection in malignant pleural effusion

Objective:To investigate the curative effect of cisplatin combined with xiongxiantai and aidi injection in malignant pleural effusion.Methods:95 patients with malignant pleural effusion selected from the geriatrics department of our hospital from November 2003 to June 2007 were divided into experimental group and control group randomly.45 patients in the control group were treated with aidi injection 50 ml in 0.9% normal saline 250 ml by intravenous drip once a day for 15 days,cisplatin 40~60 mg,dexamethoasone 10 mg and lidocaine 100 mg were injected into the thoracic cavity one to four times.Besides those,50 patients in the experimental group were added with xiongxiantai 50 mg by intrathoracic injection.The symptoms,physical signs,adverse reaction,quality of life,blood routine examination,liver function,rend function and ECG were observed,and their clinical effects were evaluated.Results:In the experimental group,the complete remission(CR) was 15 cases,the partial remission(PR) was 28 cases,the total effective rate was 86%;in the control group,CR was 9 cases,PR 16 cases,the total effective rate was 55.5%,with significant difference between two group(P<0.05).The quality of life in experimental group was improved in 32 cases accouting for 64%,the quality of life in the control group was improved in 21 case accoutin for 46.7%,with statistical significance(P<0.05).Both of two groups developed fever,nausea,vomiting anorexia,WBC and PLT decreasing and functional abnormality of liver and kidney,but without significant difference between two groups(P>0.05).Conclusion:Cisplatin combined with Xiongxiantai and aidi injection in the treatment of malignant pleural effusion is effective and safe,with light adverse reaction.