细管引流后高聚生与顺铂联合治疗恶性胸腔积液的疗效

目的：探索恶性胸腔积液内科治疗的最佳方法及疗效。方法：对42例恶性胸腔积液患者随机分成3组，每例病例均以中心静脉导管接简易负压吸引瓶进行闭式引流，待胸腔积液引流完全后．3组分别注入顺铂、高聚生或高聚生加顺铂，每周2次，重复4周，观察疗效及毒副作用。结果：引流后高聚生组、顺铂组以及高聚生＋顺铂组3组冶疗有效率分别为43％、42％和88％，两药联合疗效明显优于两药单独治疗，而高聚生和顺铂单药注入两组比较，疗效无明显差异。两药联合注入治疗恶性胸腔积液，其毒副作用无增加。结论：采用中心静脉导管闭式引流后以高聚生加顺铂联合胸腔内注入治疗恶性胸腔积液创伤小、简单方便、疗效好、毒副作用小，适合在临床推广利用。

Combination of staphylockccin aureus and DDP in malignant pleural effusions after tube thoracostomy drainage

Objective To explore the optimal medical therapy for malignant pleural effusions and its curative effect. Methods 42 patients with malignant pleural effusions were randomly assigned to receive pleural injection of DDP ,alone, staphylockccin aureus alone, or DDP plus staphylockccin aureus twice weekly for 4 weeks after their effusions were completely diminished by the chest tube thoracostomy drainage. The curative effect and the treatment-related adverse events were observed. Results There was significant difference in the curative effect between PPD plus staphylockccin aureus group and PPD alone, or staphylockccin aureus alone group after drainage. The combined therapy was evidently superior to PPD alone or staphylockccin aureus alone, while the efficacy did not differ between PPD alone and staphylockccin aureus alone. No more treatment-related adverse effects were observed in the combined therapy for malignant pleural effusions than in the two anticancer drugs used separately. Conclusion Pleural injection of staphylockccin aureus plus PPD following tube thoracostomy drainage is safe, simple, and effective in the management of malignant pleural effusions with mild adverse effects and should be popularized in the clinical practice.