猪尾式导管引流并灌注化疗治疗恶性胸、腹腔积液

目的:评价猪尾式导管置入胸、腹腔内引流恶性胸、腹腔积液并胸、腹腔内灌注化疗的近期疗效和安全性。方法:对78例经细胞病理学确诊的恶性胸、腹腔积液患者行胸、腹腔内猪尾式导管置入术,引流积液,并行胸、腹腔内灌注化疗,控制积液产生。按照WHO胸腹水评价标准评价患者近期疗效,参考Karnofsky评分标准(KPS)评价生存质量(QOL),按照NCI CTC3.0版药物毒性分级标准评价化疗不良反应。结果:全组78例患者均接受置管术并灌注化疗1～6周期,中位周期数为3。完全缓解45例,部分缓解29例,客观有效率为94.87%(74/78)。积液缓解持续时间14～180 d,中位缓解时间68 d。不良反应主要与胸腹膜刺激反应及化疗药物毒性相关,包括疼痛78%,恶心呕吐15%,发热10%,白细胞下降4%。结论:猪尾式导管置入术结合灌注化疗治疗恶性胸、腹腔积液是一种安全、有效的治疗方法,能有效控制积液生长,明显改善患者生存质量。

Application of drainage and intracavity chemotherapy through pigtail drainage tube for malignant pleural or peritoneal effusion

Objective: To evaluate the safety and effectiveness of the pleural or peritoneal drainage and intracavity chemotherapy through pigtail drainage tube for malignant pleural or peritoneal effusion patients.Methods: Seventy eight patients underwent the pleural or abdominal drainage to evacuate the fluid by pigtail drainage tube;all patients received the intracavity chemotherapy to suppress the fluid.The safety and effectiveness after therapy,the quality of life and the toxic reaction were compared.Results: All patients received pleural or abdominal Cisplatin injection after the drainage from 1 to 6 cycles,median number was 3,total number was 252.The complete remission rate was 57.69%(45/78),the partly remission rate was 37.18%(29/78),overall remission rate was 94.87%(74/78).The remission duration days was 14 to 180,the median duration days was 68.The toxic reaction includes pain(78%),nausea and vomiting(15%),fever(10%),leucocytes decrease(4%).Conclusion: The drainage and intracavity chemotherapy through pigtail drainage tube for malignant pleural or peritoneal effusion is safe and effective.