胸腔内注射吉西他滨治疗肺癌血性胸腔积液临床观察

目的 探讨在多西他赛和顺铂静脉化疗基础上胸腔内注射吉西他滨治疗肺癌血性胸腔积液的临床疗效.方法 按照入院的先后顺序,将经病理确诊的48例肺癌血性胸腔积液患者随机分为观察组与对照组各24例.在胸腔置管引流胸水后,观察组采用多西他赛＋顺铂静脉化疗与胸腔注射吉西他滨400mg/m2治疗,而对照组采用多西他赛＋顺铂静脉化疗与胸腔注射顺铂40mg/m2治疗.观察治疗前后两组患者胸水的性状及量的变化,以及药物的毒性反应.结果 观察组总有效率4周时为80％,12周为78.3％,对照组总有效率4周时为43.5％,12周为57.1％,组间比较差异有统计学意义（P＜0.05）.两组均未见严重不良反应.结论 吉西他滨胸腔内注射对改善肺癌血性胸水的性状及胸水量疗效好,且无严重不良反应,优于顺铂,具有重要的临床应用价值.

Clinical observation of intrapleural gemcitabine bloody pleural effusion of lung cancer

Objective To explore the clinical efficiency of intrapleural gemcitabine bloody pleural effusion of lung cancer in the doeetaxel intravenous chemotherapy based on cisplatin. Methods According to the order of admission, 48 eases of lung cancer diagnosed bloody pleural effusion were randomly divided into observation group and control group（n = 24）. In the chest tube drainage of pleura1 effusion, the observation group was doeetaxel intravenous chemotherapy with cisplatin and gemeitabine 400mg/m2 pleural injection therapy, while the control group was treated with docetaxel, eispla- tin chemotherapy and thoracic vein injection of eisplatin 40mg/m2 treatment. The pleural fluid characteristics and volume changes were obseved. Results The total effective rate at 4 and 12 weeks were 80% and 78.3% in the control group. The total effective rate at 4 and 12 weeks were 43.5% and 57.1% in the observation group. The difference between groups was statistically significant （P〈 0.05 ）. There were no serious adverse reactions in the patients. Conclusion Gemeitabine intrapleural injection can improve lung and chest bloody pleural effusion and has no serious adverse reac- tions.