艾迪与顺铂胸腔灌注联合静脉应用培美曲塞二钠治疗肺腺癌恶性胸腔积液的临床观察

目的 探索艾迪与顺铂胸腔灌注联合静脉应用培美曲塞二钠治疗肺腺癌合并恶性胸腔积液的临床效果。 方法 选取2018年6月—2019年4月蚌埠市第三人民医院收治的68例肺腺癌合并恶性胸腔积液的病例,采用随机数字表法分为观察组(34例)及对照组(34例),2组患者经B超探查定位后,置入中心静脉导管,间断引流后B超探查胸水,待胸腔积液充分引流后,予以胸腔灌注。2组患者在给予静脉应用培美曲塞二钠基础上,观察组给予艾迪注射液、顺铂胸腔灌注,对照组给予顺铂胸腔灌注。每周期顺铂(50 mg/m2)分2~3次进行胸腔灌注,艾迪注射液每次给予50 mL,每周期灌注2次,4周期化疗结束1个月后采用WHO恶性胸腔积液疗效标准评估临床疗效,依据体力KPS评分评定患者的生存质量,参照WHO抗癌药物毒副作用标准评估治疗周期中药物毒副反应发生率。 结果 在临床疗效方面,观察组总有效率(82.35%)高于对照组(58.82%),差异具有统计学意义(P=0.033);在生活质量方面,观察组KPS评分总有效率(88.24%)高于对照组(64.71%),差异有统计学意义(P=0.022);在毒副反应方面,观察组在乏力(P=0.004)、Ⅲ~Ⅳ级毒副反应(P=0.031)发生率显著低于对照组,在骨髓抑制、肝肾功能损害、发热、胃肠道反应等方面,2组差异无统计学意义(均P>0.05)。 结论 在顺铂胸腔灌注联合静脉应用培美曲塞二钠治疗肺腺癌胸腔积液的基础上,使用艾迪注射液胸腔灌注能够提升临床治疗效果,减少患者严重毒副反应发生率,同时能够提升患者体力,改善生活质量。 

Clinical observation of the treatment of malignant pleural effusion of lung adenocarcinoma by intravenous chemotherapy with Aidi injection and cisplatin pleural perfusion combined with pemetrexed disodium

Objective To explore the clinical effect of Aidi injection and cisplatin pleural perfusion combined with pemetrexed disodium in the treatment of lung adenocarcinoma with malignant pleural effusion. Methods Total 68 cases of lung adenocarcinoma with malignant pleural effusion admitted to the Respiratory Department of the Third People's Hospital of Bengbu City from June 2018 to April 2019 were randomly divided into observation group(34 cases) and control group(34 cases). After B-ultrasound exploration and positioning, all patients were placed into the central venous catheter, and then the pleural effusion was detected by B-ultrasound after intermittent drainage. After the pleural effusion was fully drained, the pleural perfusion was performed. On the basis of intravenous application of pemetrexed disodium, the patients in the observation group were given Aidi injection and cisplatin chest perfusion, while those in the control group were given cisplatin chest perfusion. Cisplatin(50 mg/m2) was infused into the thorax 2-3 times a cycle, Aidi injection was given 50 mL each time, twice a week. One month after the end of four cycles of chemotherapy, the clinical efficacy was evaluated by the WHO standard for the efficacy of malignant pleural effusion, the quality of life was evaluated according to the physical KPS score, and the incidence of drug toxicity was evaluated according to the WHO standard for the toxicity and side effects of anticancer drugs. Results In the clinical efficacy, the total effective rate of the observation group(82.35%) was better than that of the control group(58.82%), P=0.033. In the quality of life, the total effective rate of KPS score of the observation group(88.24%) was better than that of the control group(64.71%), P=0.022. In terms of side effects, the incidence of asthenia(P=0.004) and class Ⅲ-Ⅳ side effects(P=0.031) in the observation group was significantly lower than that in the control group. In terms of myelosuppression, liver and kidney function damage, fever, gastrointestinal reactions, there was no significant difference between the two groups(all P>0.05). Conclusion On the basis of cisplatin combined with pemetrexed disodium in the treatment of pleural effusion of lung adenocarcinoma, the use of Aidi injection can improve the clinical effect, reduce the incidence of serious side effects, improve the physical strength and improve the quality of life.