草分枝杆菌联合顺铂治疗恶性胸腔积液的临床观察

目的探讨恶性胸腔积液内科最佳治疗方法及疗效。方法对46例恶性胸腔积液患者随机分为两组,每组病例均经中心静脉导管连接简易负压吸引瓶进行闭式引流,待胸腔积液引流完全后,两组分别注入草分枝杆菌(MP)加顺铂(DDP,即观察组)、单用顺铂(DDP,即对照组),每周2次,重复4周,观察其疗效、毒副作用、生活质量评估(KPS评分)、1年存活率。结果观察组疗效明显优于对照组,两组毒副作用比较差异无显著性。观察组在治疗前后生活质量评估(KPS评分)差异有显著性(P<0.05),但两组1年存活率差异无显著性(P>0.05)。结论草分枝杆菌联合顺铂治疗能明显减少恶性胸腔积液复发,提高患者生活质量,但不能提高患者存活率,不能替代全身化疗。

The outcomes and toxicity of DDP in combination with MP for treatment of patients with malignant pleural effusion

Objective To outline the efficacy and to identify the best conventional treatment options for patients with malignant pleural effusion(MPE). Methods 46 patients with MPE were randomly divided into 2 groups.The thoracic close drainage was performed for all subjects using a central venous catheterization set connected with a simple vacuum suction vase.The observation group received DDP plus Mycobacterium phle(MP) which were injected into thoracic cavity,the control group received DDP alone,after the pleural effusion disappeared,twice a week,repeated for 4 weeks.The outcomes,side effects,the quality of life(using Kamofsky performance status,KPS evaluation),and 1-year survivak rate were recorded. Results The response rate of the observation group is superior to that of the control group,and the incidence of adverse effects in the observation group was similar to the control group.In the observation group,the comparsison of the KPS scores before and after treatment showed there was statistical difference(P<0.05).Compared the observation group to the control group,the one-year survival rate was similar,there was no statistical difference(P>0.05). Conclusion DDP in combination with MP can reduce relapse of MPE obviously,and to raise the patients quality of life,but it can't increase the survival rate and can't replace for the whole body chemotherapy.