香菇多糖注射液胸腔灌注治疗肺癌及胸膜间皮瘤所致恶性胸腔积液
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【中图分类号】R734 【文献标识码】B 【文章编号】1672-6383(2010)11-0011-02
【摘要】目的:探讨香菇多糖注射液胸腔灌注对肺癌及胸膜间皮瘤所致恶性胸腔积液的治疗作用。方法:对2008年5月至2010年7月来经胸腔内注射香菇多糖治疗的临床诊断为肺癌及胸膜间皮瘤所致胸腔积液患者82例的临床资料进行分析。结果:完全缓解37例(45.12%),部分缓解42例(51.22%),无效3例(3.66%),总有效率96.34%,中位体力状况达80分,无明显不良反应,有37例(45.12%)出现不同程度发热,26例(31.71%)出现患侧胸痛,均经3天治疗后消失。结论:应用国产香菇多糖胸腔内注射治疗肺癌及胸膜间皮瘤所致恶性胸腔积液有效、安全,并且能改善患者体力状况,值得临床推广使用。
【关键词】恶性胸腔积液;香菇多糖
Black mushrooms many the sugar inject liquid chest to infuse to note treatment lung cancer and chest film skin lump with the result that m alignant the chest accumulate a liquid
Zhao Yaoshuo
【Abstract】Purpose:Study black mushrooms many the sugar inject liquid chest to infuse to note skin lump to lung cancer and chest film with the result that m alignant the chest accumulate a liquid of treatment function.Method:To 2008 May to 2010 July come through chest inside inject black mushrooms many sugar treatment of clinical diagnosis is lung cancer and chest film skin lump with the result that the chest accumulate a liquid sufferer's 82 example clinical data to carry on analysis.Result:Complete alleviate 37(45.12%), part alleviate 42(51.22%), invalid 3(3.66%), total efficient 96.34%, medium the physical strength condition reach to 80 cent, have no obvious bad reaction, appear 37(45.12%) dissimilarity the degree have fever, 26(31.71%) appear to suffer from side chest pain, all through 3 day treatment empress disappear.Conclusion:Application the domestic black mushrooms much inject treatment lung cancer and chest film inside sugar chest skin lump with the result that m alignant the chest accumulate a liquid valid, safety, and ability improvement sufferer physical strength condition, worthy of clinical expansion usage.
【Key words】M alignant chest accumulate a liquid;Black mushrooms many sugar
近3年来我们对肺癌及胸膜间皮瘤所致恶性胸腔积液患者采用胸腔内注射香菇多糖进行治疗,取得显著疗效,现报告如下。
1.临床资料
1.1 病例选择:对2008年5月至2010年7月82例胸腔积液患者,其中男55例,女27例,年龄31～72岁。均经肺CT、支气管镜或胸膜活检术等确诊为肺癌58例(腺癌34例,鳞癌16例,小细胞癌4例,未分化癌4例),胸膜间皮瘤24例,体力状况(Kanofsky标准)大于60分,中位体力状况70分。
1.2 药物与方法:经胸部B超定位胸腔积液,用深静脉穿刺导管经皮穿刺胸腔内置管,连接负压引流袋引流尽胸腔积液,引流速度24小时不超过1500ml,3-5天排尽胸液;B超证实积液基本引流完后,将香菇多糖针6mg溶于20ml生理盐水中胸腔内注入,注入后嘱患者上床翻动,每5分钟变换一次体位,共20分钟。连续2周,每周2次。香菇多糖注射液(商品名:易能)为南京易亨制药有限公司生产。
1.3 疗效评定:2周后评定疗效疗。疗效评定标准根据李振编恶性肿瘤的化疗与免疫治疗制定[1]。完全缓解(CR):胸腔积液完全消失,经胸片或B超证实仅余下胸膜增厚,并维持30天以上;部分缓解(PR):症状改善,胸腔积液减少大于1/2上,并维持30天以上;无效(NR):胸腔积液减少小于1/2,继续增长需反复抽胸腔积液者。CR+PR为总有效率。KPS评分:按WHO标准前后各记录一次。
2.结果
2.1 疗效观察:本组82例中,CR37例(45.12%),PR42例(51.22%),NR3例(3.66%),总有效率96.34%。肺腺癌CR15例,PR19例;肺鳞癌CR8例,PR8例;小细胞未分化癌CR2例,PR2例;未分化癌CR2例,PR2例;胸膜间皮瘤CR10例,PR11例,NR3例。中位体力状况达80分,见表1 ......
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