沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液81例疗效分析

目的 探讨沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液技术的临床应用价值。方法 在超声引导下对81例恶性心包积液患者沿心脏切线方向进行心包穿刺并植入5-FU缓释粒子，治疗后每周行超声检查，4周后评价疗效，以同期心包置管引流并腔内化疗的45例患者作为对照。结果 81例均一次性穿刺成功。缓释化疗粒子植入治疗后第4周超声复查，71例完全缓解，8例部分缓解，2例无效。总有效率达97.53%，高于置管引流组（77.78%），差异有统计学意义（P<0.01）。结论 沿心脏切线方向穿刺植入5-FU缓释粒子治疗恶性心包积液操作安全，疗效好，不良反应少，是目前较为理想的治疗方案。

Therapy effect of 5-FU palliative implanted through puncturing along cardiac tangent direction in 81 patients with malignant pericardial effusion

Objective To investigate the clinical value of the 5-FU sustained-release particles implanted through puncturing along the cardiac tangent direction for malignant pericardial effusion. Methods 81 patients with malignant pericardial effusion were treated by pericardiocentesis guided by ultrasound and 5-FU palliative particles were implanted into the pericardial cavity. The puncturing path was along the cardiac tangent direction. Ultrasound examinations were used every week after the treatment. The efficacy was evaluated four weeks after the treatment. The 45 patients treated by pericardial catheter drainage and intracavitary chemotherapy at the same period were served as controls. Results The puncturing success rate was 100% in the 81 cases. Ultrasound reviews showed that complete remission occurred in 71，partial remission in 8, and no response in 2 cases four weeks after the treatment. The total remission rate was 97.53%, which was significantly higher than that in the control group(77.78%, P<0.01). Conclusion It is a new ideal method to treat malignant pericardial effusion to implant 5-FU sustained-release particles through puncturing along the cardiac tangent direction for its high safety and efficacy and less adverse reactions.