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目的采取中心静脉导管置管引流联合胸腔局部治疗,评估综合治疗恶性肿瘤患者伴恶性胸腔积液的近期临床疗效。方法 2012年5月—2014年10月收集恶性肿瘤伴恶性胸腔积液的84例患者,采用随机对照的方法划分为观察组56例和对照组28例。对照组行全身静脉化疗配合胸腔内放置中心静脉导管引流;观察组在对照组治疗的基础上,行胸腔局部治疗,具体措施包括:胸腔注入抗肿瘤药物、胸腔注入生物反应调节剂、胸膜粘连术等综合疗法。结果二组患者中有3例患者出现胸膜反应,5例患者出现发热症状,给予积极对症支持治疗后缓解,其余患者均顺利完成治疗,未发生严重得并发症,观察组胸腔积液缓解总有效率达76.79%,生活质量KPS评分较高,患者无进展生存期(PFS)和总生存期(OS)明显延长。结论胸腔穿刺抽液术联合胸腔局部治疗的综合疗法,对恶性肿瘤患者出现恶性胸腔积液疗效确切,一方面能明显改善患者呼吸系统的症状,提高肿瘤患者的生活质量;另一方面可一定程度上延长恶性肿瘤患者无进展生存期(PFS)和总生存期(OS)。值得进一步做大样本临床观察与研究。
Objective To take the central venous catheter drainage combined with local treatment of thoracic cavity to evaluate the comprehensive clinical treatment of malignant tumor patients with malignant pleural effusion. Methods From May 2012 to October 2014, 84 patients with malignant tumor and malignant pleural effusion were divided into observation group (56 cases) and control group (28 cases) by randomized controlled method. The control group received intravenous chemotherapy combined with thoracic drainage in the central venous catheter. On the basis of the control group, the observation group received local treatment of thoracic cavity. The specific measures included thoracic injection of anti-tumor drugs, thoracic injection of biological response modifiers, pleural adhesions And other comprehensive treatment. Results In the two groups of patients, 3 patients had pleural reaction, 5 patients had fever symptoms, given symptomatic symptomatic and symptomatic treatment and relief, and the rest were successfully treated without serious complications. The patients in the observation group always had pleural effusion relief The effective rate was 76.79%. The KPS score of life quality was higher, and the progression-free survival (PFS) and overall survival (OS) of patients were significantly longer. Conclusions Combined thoracentesis and drainage combined with local treatment of thoracic cavity has definite curative effect on malignant pleural effusion in patients with malignant tumors. On the one hand, it can significantly improve the respiratory symptoms and improve the quality of life of patients with cancer; on the other hand, Prolong the progression-free survival (PFS) and overall survival (OS) of patients with malignant tumors. It is worth further to enlarge the sample clinical observation and research.