铜绿假单胞菌注射液联合乌司他丁治疗晚期恶性体腔积液的临床分析

目的 研究铜绿假单胞菌注射液联合乌司他丁胸腹腔注射治疗晚期恶性体腔积液的安全性及有效性.方法 52例晚期恶性胸腹腔积液患者,随机分为单药铜绿假单胞菌注射液组26例、铜绿假单胞菌注射液联合乌司他丁组26例.所有患者治疗前均行胸腹腔超声定量、定位检查后予以积液引流,引流后单药组胸腹腔一次性注射铜绿假单胞菌注射液10 ml,两药联合组引流后给予胸腹腔一次性注射铜绿假单胞菌注射液10 ml及乌司他丁30万U,每周2次,连续注药4次后对治疗前后疗效及患者不良反应进行评估.结果 单药铜绿组完全缓解（CR）1例,部分缓解（PR）8例,有效率34.6％;两药联合组：CR 2例,PR 14例,有效率61.5％,差异有统计学意义（P＜0.05）.单药组注药后出现发热者8例,两药联合组出现发热3例,两药联合组与单药组相比,发热明显减少,但差异无统计学意义（P＞0.05）.结论 铜绿假单胞菌注射液联合乌司他丁胸腹腔注射,较单药铜绿组有效率明显提高,不良反应降低.

Clinical observation of the patients with malignant coelom effusion treated with pseudomonas aeruginosa injection combined with ulinastatin by body cavity injection

Objective　To evaluate the effect and safety of pseudomonas aeruginosa injection (PA-MSHA) combined with ulinastatin (UTI) injection in the treatment of patients with malignant pleural effusion and/or ascites. Methods　52 patients were randomly divided into PA-MSHA group and PA-MSHA combined with UTI group, each group including 26 patients. All patients were given ultrasonic testing before treatment. The single drug group was given PA-MSHA 10 ml intrapleural and/or intraperitoneal injection. The two-drug combination group was given PA-MSHA 10ml and UTI 300 000 U, twice per week. Evaluation of the efficacy and adverse reaction was performed after 4 times. Results　The effective rate of single PA-MSHA group was 34.6 % (CR 1 case, PR 8 cases), while the effective rate of PA-MSHA combined with UTI group was 61.5 % (CR 2 cases, PR 14 cases). The effective rate of PA-MSHA combined with UTI group was statistically higher than that of single PA-MSHA group (P < 0.05). 8 cases got fever in single PA-MSHA group, 3 cases in PA-MSHA combined with UTI group got fever, side effect had no statistical significance (P > 0.05). Conclusion　PA-MSHA combined with UTI has better effect in the treatment of patients with malignant pleural effusion and/or ascites compared with single PA-MSHA, and both treatments have low side effects.