胞必佳\顺铂腔内注入治疗恶性胸液疗效观察

http://www.100md.com 2010年7月1日 卞秀华

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     [摘要]目的观察恶性胸液腔内注入胞必佳、顺铂的临床疗效。方法36例晚期癌症并发胸腔积液患者随机分为N-CWS组20例和对照组16例。治疗组腔内注入N-CWS 600ug、DDP 40mg/m2,对照组腔内注入DDP40mg/m2。观察积液控制情况、KPS评分的变化。结果治疗组胸腔积液控制有效率(CR+PR=85%),较对照组有显著差异(P<0.05),KPS评分提高有效率90%,较对照组有非常显著差异(P<0.01)。结论N-CWS、DDP联合腔内注入治疗恶性胸液效果明显,并能明显提高病人生活质量。

    [关键词]胸腔积液;胞必佳(N-CWS);顺铂(DDP);治疗

    [中图分类号]R730.6[文献标识码]A [文章编号] 1005-0515(2010)-7-003-01

    Clinical study of nocardia rubracell wall skeleton(N-CWS)and cisplatin (DDP)in treating m alignant pleural effusion

    Bian xiuhua

    (Traditional Chinese Medicine Hospital of Jia Xiang Shandong Jia Xiang 272400)

    [Abstract]ObjectiveToobserve the treatment of N-CWS、DDP on the patients with m alignant pleural effusion.Methods There were 36 patients with m alignant pleural effusion in the study.36 cases were randomly divided into two groups(N-CWS group and control group).Each case was released the effusion。When therc was on evidence of fluid in the pleural space as assessed by plain chest roentgenography or B-superson.10ml of 2%lidocaine 600ug of-CWS 40ml of saline solution (0.9%)、5mg of DXM and/or 40mg/m2 of DDP Was injected into pleural space。The patients were asked to change。position to allow adequate distribution of medicines.The changes of pleural effitsion were recorded,KSP score was evaluated in both groups.ResultsIn N-CWS group the clinical effects(CR+PR=85%)weremagnificently decreased than control group(x2=5.13),(P<0.05),KPS score was significantly improved(P<0.01)。ConclusionThe treatment of N一CWS、DDP on the patients with m alignant pleural effusion is a effective way.It may improve qualityof life in patients.

    [Keywords]norcardia rubraell wall skeleton(N-CWS);pleural effusin;cisplatin(DDP)

    胞必佳-红色诺卡氏菌细胞壁骨架(N-CWS)是一种生物反应调节剂,具有理想的抗肿瘤免疫效应。我科应用N-CWS、顺铂(DDP)联合腔内注入治疗恶性胸腔积液病人,疗效明显,报告如下。

    1 材料与方法

    1.1 病例选择经病理学或细胞学检查证实的36例恶性胸液病人,其中肺腺癌l4例,鳞癌6例,小细胞肺癌8例,胸膜间皮瘤8例。男21例,女15例,年龄30-77岁。复治病人l2例,距上次抗肿瘤治疗至少l月。Kamofsky评分>50分;临床分期:Ⅲb期20例,Ⅳ期l6例。预计生存期3个月以上,无心、肝、肾功能障碍。治疗组20例,对照组l6例。

    1.2 治疗方法B超定位后尽量抽尽胸水,将2%利多卡因10ml、N-CWS600ug、生理盐水40ml、DDP 40mg/m2、地塞米松5mg注入胸腔内,拔针后嘱病人缓慢转动体位,以使药液与胸膜接触,每周一次,共2-6次。对照组不用N-CWS,余同治疗组。治疗前后检查B超、血常规、肝、肾功能,并观察病人胸水吸收情况、Kamofsky评分的变化。

    1.3 疗效评定胸水疗效评定标准参照Millar标准[1]:完全缓解(CR):胸水完全消失,且稳定4周以上;部分缓解(PR):胸水减少1/2以上维持4周以上;无效(NE):未达到上述指标者。KPS评分,CR:KPS评分增加20分以上;PR:KPS评分增加l0分以上;NE:KPS评分增加小于l0分或不增加 ......

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