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目的:观察置入中心静脉导管胸腔闭式引流后胸腔灌注核糖核酸Ⅱ联合卡铂治疗乳腺癌转移导致恶性胸水的临床疗效。方法:34例乳腺癌转移导致恶性胸水的患者置入中心静脉导管后行胸腔闭式引流,待胸液排尽后,随机分成两组,治疗组18例用0.9%氯化钠注射液50 ml+2%利多卡因5 mg+地塞米松5 mg+核糖核酸Ⅱ400 mg+卡铂200 mg,胸腔内注射,每周2次,连续3周。对照组不用核糖核酸Ⅱ,其他同治疗组。观察两组治疗前后胸水变化及不良反应。结果:治疗组有效率94.4%。明显高于对照组的56.25%(P<0.01)。治疗组主要不良反应为发热、胸痛,发生率分别为16%(3/18)和11%(2/18)。对照组主要不良反应为骨髓抑制、消化道反应、发热,发生率分别为18%、25%和18%(3/16)。治疗组不良反应发生率明显低于对照组(P<0.05)。结论:置入中心静脉导管胸腔闭式引流后胸腔灌注核糖核酸Ⅱ联合卡铂治疗因乳腺癌转移导致的恶性胸水,不良反应轻,疗效肯定。
Objective: To observe the curative effect of thoracic perfusion ribonucleic acid Ⅱ combined with carboplatin in the treatment of breast cancer metastasis leading to malignant pleural effusion after thoracic drainage by central venous catheter. Methods: Thirty-four patients with malignant pleural effusion who had metastatic breast cancer were treated with closed thoracic drainage. After the pleural effusion was drained, they were randomly divided into two groups. In the treatment group, 18 patients were treated with 0.9% sodium chloride injection 50 ml + 2% lidocaine 5 mg + dexamethasone 5 mg + RNA II400 mg + carboplatin 200 mg, intrapleural injection twice a week for 3 weeks. The control group without ribonucleic acid Ⅱ, the other with the treatment group. The changes of pleural effusion and adverse reactions in both groups before and after treatment were observed. Results: The treatment group was 94.4% efficient. Significantly higher than 56.25% of the control group (P <0.01). The main adverse reactions in the treatment group were fever and chest pain, with rates of 16% (3/18) and 11% (2/18), respectively. The main adverse reactions in the control group were myelosuppression, gastrointestinal reactions and fever, with rates of 18%, 25%, and 18%, respectively (3/16). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P <0.05). CONCLUSION: Pleural perfusion of ribonucleic acid Ⅱ combined with carboplatin after thoracic drainage of central venous catheter can treat malignant pleural effusion caused by breast cancer metastasis. The adverse reactions are mild and the curative effect is definite.