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目的观察微卡胸膜腔内注入治疗恶性胸腔积液的效果和不良反应。方法2005年8月至2006年12月病理确诊的原发性支气管肺癌并恶性胸腔积液患者52例,胸膜腔内置入细管并接负压瓶,引流完胸腔积液后,随机分为两组,一组共27例胸腔内注入微卡225ug(微卡组);另一组共25例注入高聚生4000单位(高聚金组),观察对比两组的效果和不良反应。结果微卡组治疗效果CR6例、PR15例、NC4例、PD2例,有效率77.8%;高聚金组CR4例、PR16例、NC5例,有效率80.0%,两组的有效率无差异显著性(P>0.05)。微卡组患者80.0%(16/20),高聚金组81.2%(13/16)治疗后气促胸闷症状均有不同程度的改善甚至消失,两组比较无差异显著性(Fisher′s精确检验,P=1.00)。两组kamofsky评分治疗后比治疗前提高,微卡组平均提高(17.8±7.5)分;高聚金组(20.8±8.6)分,两组比较无差异显著性(t=1.35,P=0.183),两组均无严重不良反应事件,微卡组发热发生率33.3%,高聚生组48.0%,以低、中度发热为主,持续1～3d,经对症处理可缓解。结论微卡用于治疗恶性胸腔积液效果较好,不良反应轻微。
Objective To observe the effect of micro-card pleural cavity injection and treatment of malignant pleural effusion and adverse reactions. Methods From August 2005 to December 2006, 52 patients with primary bronchogenic carcinoma and malignant pleural effusion were diagnosed pathologically. The pleural cavity was placed in a small tube and connected to a negative pressure bottle. After pleural effusion was drained, the pleural cavity was randomly divided into two groups Group, a group of 27 cases of intracardiac injection of micro-card 225ug (micro-card group); the other group, a total of 25 cases injected hyper-4000 units (high-poly-gold group) were observed and compared the two groups of effects and adverse reactions. Results There were 6 CR cases, 15 PR cases, 4 NC cases and 2 PD cases, the effective rate was 77.8% in the micro-card group. There were no significant difference between the two groups in CR4, PR16 and NC5 cases (P> 0.05). In the micro-card group, 80.0% (16/20) and 81.2% (13/16) of the high-polygem group had improvement or even disappearance of chest tightness. There was no significant difference between the two groups (Fisher’s exact Test, P = 1.00). The kamofsky scores in both groups were significantly higher than those before treatment (17.8 ± 7.5) in the micro-card group and 20.8 ± 8.6 (20.8 ± 8.6) in the high-polyjin group, with no significant difference between the two groups (t = 1.35, P = 0.183) . There were no serious adverse events in both groups. The incidence of fever in the microcapsules was 33.3% and that in the hypercondensation group was 48.0%, mainly in low and moderate fever, lasting 1 to 3 days. The symptomatic treatment was relieved. Conclusion Micro-card for the treatment of malignant pleural effusion better, minor adverse reactions.