论文部分内容阅读
目的探讨胸腔灌注万特普安治疗肝切除术后中大量胸腔积液患者的有效性和安全性。方法选取郑州大学附属肿瘤医院2013年1月-2016年12月收治的44例肝肿瘤切除手术患者。所有患者术后15~30 d复查时均发现中、大量胸腔积液。根据治疗方法不同将患者随机平均分为治疗组和对照组,每组各22例。治疗组经导管注入万特普安3支(每支1.0 ml,含菌1.8×109个)+生理盐水30 ml+2%利多卡因10 ml+地塞米松10 mg,1次/3 d;对照组不注入任何药物。分析两组治疗结果及不良反应情况。结果治疗组治愈率为86.3%、有效率为90.9%,对照组治愈率为40.9%、有效率为59.1%,治疗组显著优于对照组,差异有统计学意义(P<0.05)。治疗组平均引流时间为(6.8±1.6)d,较对照组的(12.5±1.4)d显著缩短;治疗组平均住院日为(9.5±1.3)d,较对照组的(14.7±0.9)d显著缩短;差异均有统计学意义(均P<0.05)。治疗组出现胸部疼痛7例(轻度6例、中度1例),发热5例(均为轻度),均经对症治疗后好转;对照组无胸痛、发热等不良反应发生。结论胸腔灌注万特普安治疗肝切除术后中大量胸腔积液患者疗效确切,不良反应易处理、可耐受,值得临床进一步推广应用。
Objective To investigate the efficacy and safety of thoracic perfusion in the treatment of large pleural effusion after hepatectomy. Methods Forty-four patients underwent hepatectomy from January 2013 to December 2016 in Cancer Hospital of Zhengzhou University. All patients were 15 to 30 days after the review found that a large number of pleural effusion. According to different treatment methods, patients were randomly divided into treatment group and control group, with 22 cases in each group. In the treatment group, there were 3 diabetic patients (1.0 ml each with 1.8 × 109 bacteria), 30 ml normal saline, 10 ml 2% lidocaine and 10 mg dexamethasone once a day for 3 days. Group does not inject any drugs. Analysis of two groups of treatment results and adverse reactions. Results The cure rate was 86.3% in the treatment group and the effective rate was 90.9%. The cure rate in the control group was 40.9% and the effective rate was 59.1%. The treatment group was significantly better than the control group (P <0.05). The average drainage time in the treatment group was (6.8 ± 1.6) d, which was significantly shorter than that in the control group (12.5 ± 1.4) d. The mean length of stay in the treatment group was (9.5 ± 1.3) days, significantly higher than that in the control group (14.7 ± 0.9) d Shortened; the difference was statistically significant (both P <0.05). In the treatment group, there were 7 cases of chest pain (6 cases in mild and 1 case in moderate) and 5 cases in fever (all mild), which were all improved after symptomatic treatment. The control group had no adverse reactions such as chest pain and fever. Conclusions Thoracic infusion of Vantutecan in the treatment of massive pleural effusion after hepatectomy patients curative effect is exact, easy to deal with adverse reactions, tolerable, it is worth further clinical application.