体外高频热疗联合化疗治疗胸腔恶性积液的临床观察(1)
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【摘要】目的:晚期肺癌常伴有恶性胸腔积液,严重影响了患者的生活质量及生存时间。胸腔内药物注射是治疗恶性胸腔积液最常见的方法之一,但疗效在50%左右。本研究的目的是观察热疗联合化疗治疗恶性胸腔积液的疗效、毒副反应和患者的生活质量。方法:确诊为晚期肺癌所致恶性胸腔积液的初治患者60例,分为热化疗和单纯化疗两组。热化疗组:热化疗组患者:胸腔注射顺铂60mg、地塞米松5mg、2%利多卡因10ml/次,嘱患者在注药后1小时内每15分钟变换体位1次,使药物与胸膜广泛接触。每周2次。胸腔局部化疗后1小时进行患侧胸腔的深部热疗,采用HG-2000体外高频热疗机,根据患者实际耐受情况设定治疗功率1000-1200W,温度控制在42～43.5℃,治疗时间60分钟,每周2次,1周为1个周期,共2周期。单纯化疗组患者给予胸腔注射顺铂60mg、地塞米松5mg、2%利多卡因10ml/次,嘱患者在注药后1小时内每15分钟变换体位1次,使药物与胸膜广泛接触。每周2次,1周为1个周期,共2周期。患者在治疗期间,常规给予昂丹司琼止吐,适当水化利尿,保肝护胃及对症支持治疗。结果:热化疗组控制胸水的总有效率为90.0O%,单纯化疗组为66.67%(P=0.024)。两组毒副反应仅见一过性发热。结论:采用热疗联合化疗治疗恶性胸腔积液疗效确切,毒副反应小,安全性高。
【关键词】体外高频热疗;顺铂;恶性胸腔积液
External high frequency thermotherapy combined clinical efficacy of chemotheraphy for m alignant pleural effusion
DONG gaofu WANG jinfu YANG feng ZHOU xiaoxing WANG xiaoqiang YAO xiaoqing
【Abstract】Objective:M alignant pleural effusion is one of the common complications inpatients with advanced lung cancer.Intracavitary injection of drug is a usual method,but the overallresponse rate is about 50% . The aim of this.study is to evaluate the efficacy of external high frequency thermotherapy combined with intracavitary injection of drug for m alignant pleural effusion.Methods:Sixty patients with m alignant pleural effusion caused by lung cancer were randomized into two groups after puncture or closed drainage.Thirty patients were treated with External high frequency thermotherapy combined intrapleural injection of cisplatinfor 2 cycles,the other patients were treated only with intrapleural injection of cisplatinfor 2 cycles.Results:The response rate of pleural effusion was 90.00%in the combination group and 66.67%in the chemotherapy group(P=0.024).The quality of life in the combination group was significantly better than that in the chemotherapy group .Conclusion:External high frequency thermotherapy combined intracavitary injection is effective and secure in treatment of m alignant pleural effusion.
【Key Words】External high frequency thermotherapy;Cisplatin;M alignant pleural effusion
【中图分类号】R9358【文献标识码】B【文章编号】1005-0515(2010)011-0023-02
晚期肺癌常伴有恶性胸腔积液,严重影响了患者的生活质量及生存时间。胸腔内药物注射是治疗恶性胸腔积液最常见的方法之一,但疗效在50%左右。我们于2007年1月～2010年6月采用体外高频热疗联合顺铂化疗治疗恶性胸腔积液,取得良好的疗效,现报告如下 ......
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