胸腔镜胸膜固定术联合顺铂和鸦胆子油 治疗恶性胸腔积液疗效观察

Clinical effects of thoracoscopic pleurodesis combined with cisplatin and brucea javancia seed oil thoracic perfusion in treatment of patients with malignant pleural effusion

摘要:

目的 探讨胸腔镜胸膜固定术联合顺铂和鸦胆子油治疗恶性胸腔积液（MPE）的临床疗效。 方法 将66例MPE患者平均随机分为A、B、C3组，A组接受顺铂胸膜腔内灌注治疗；B组接受胸腔镜胸膜固定术联合顺铂胸膜腔内灌注治疗；C组接受胸腔镜胸膜固定术联合顺铂及鸦胆子油胸膜腔内灌注治疗。观察并比较以上3组患者的临床治疗总有效率、Karnofsky生活质量评分（KPS）以及不良反应发生率。 结果 A、B、C组治疗有效率分别为72.72%、90.90%以及95.45%，B组及C组显著高于A组（P <0.05）；所有患者治疗后KPS评分均显著升高（P <0.05），治疗后B组及C组显著高于A组（P <0.05），同时C组显著高于B组（P <0.05）；不良反应发生率C组显著低于A组及B组（P <0.05）。 结论 胸腔镜胸膜固定术联合顺铂和鸦胆子油治疗恶性胸腔积液疗效肯定，可改善患者生活质量并减轻不良反应。

Abstract:

【Objective】 To explore the clinical effects of thoracoscopic pleurodesis combined with cisplatin and brucea javanica seed oil thoracic perfusion in treatment of patients with malignant pleural effusion (MPE). 【Methods】 66 patients with MPE were divided into group A, B and C evenly and randomly. Group A received cisplatin thoracic perfusion; group B received thoracoscopic pleurodesis combined with cisplatin; Group C received thoracoscopic pleurodesis combined with cisplatin and brucea javanica seed oil. Clinical efficacy, KPS and side effects were observed and compared.【Results】 Clinical efficacy of group A, B and C were 72.72%, 90.90% and 95.45%, respectively. Efficacy of group B and C was significantly higher than group A (P <0.05); KPS of all patients increased significantly after treatments (all P <0.05), KPS of group B and C was significantly higher than group A after treatments (P <0.05), KPS of group C was significantly higher than group B (P <0.05) at the same time; side effects occurrence of group C was significantly lower than that of group A and B (P <0.05). 【Conclusion】 There is a confirmed effect of thoracoscopic pleurodesis combined with cisplatin and brucea javanica thoracic perfusion in treatment of MPE, which improves life quality and alleviates side effects.