乌体林斯注射液治疗恶性胸腔积液的临床研究(1)
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[摘要] 目的 观察和评价乌体林斯治疗恶性胸腔积液的疗效及不良反应。方法 将136例恶性胸腔积液患者随机分为治疗组和对照组各68例，治疗组单用乌体林斯胸腔内注射，对照组单用顺铂胸腔内注射，观察近期疗效、活动状况和不良反应。结果 治疗组的近期疗效、活动状况改善程度均优于对照组(P<0.05)；治疗组不良反应少，仅为发热、胸痛、消化道反应；患者生活质量得到明显改善。结论 乌体林斯治疗恶性胸腔积液的疗效确切，能明显改善患者的生活质量。
[关键词] 胸腔积液；乌体林斯；胸腔注射
[中图分类号] R979.1 [文献标识码] B [文章编号] 1673-9701(2011)35-148-02
Clinical Study of Therapy for M alignant Pleural Effusion by Intrapleural Injection of Mycobacterium Phlei F. U. 36
LIU Bin LI Jing PAN Li LIU Guangyuan YU Ping
Department of Pulmonary Tumor，Sichuan Cancer Hospital，Chengdu 610041， China
[Abstract] Objective To observe and evaluate the efficacy and side effect of therapy for m alignant pleural effusion with mycobacterium phlei F. U. 36. Methods All 136 patients histologically proved m alignant pleural effusion were randomized into treatment group and control group；68 patients were treated with mycobacterium phlei F. U. 36 intrapleural injection only(treatment group)，and 68 patients were treated with cisplatin intrapleural injection only(control group). The therapeutic efficacy，change of performance and side effects were compared between the two groups. Results The therapeutic efficacy and performance improvement were higher in treatment group than that of control group(P<0.05). The side effects of treatment group were only low fever，mild pleurodynia and gastrointestinal reaction. The quality of life of treatment group was improved obviously. Conclusion Intrapleural injection of mycobacterium phlei F. U. 36 has efficacy evidently in treatment of m alignant pleural effusion，and improved the quality of life.
[Key words] Pleural effusion；Mycobacterium phlei F. U. 36；Intrapleural injection
恶性胸腔积液是晚期肿瘤患者常见的并发症，约占整个胸腔积液的25%~30%[1]，尤其在晚期肺癌患者中更加多见。由于胸腔积液生长迅速，患者常因大量胸腔积液引起胸闷、气促、呼吸困难、难以平卧、活动受限，导致患者生活质量下降，严重时可危及生命。因此，处理好恶性胸腔积液，不但可减轻患者痛苦，还可改善患者的生活质量。乌体林斯是灭活的草分枝杆菌制剂，是一种多功能生物反应调节剂，进入机体后可激发人体免疫应答，并具有非特异抗肿瘤作用，临床用于多种恶性肿瘤的辅助治疗。2008年12月～2011年6月我们采用乌体林斯注射液治疗恶性胸腔积液，取得比较好的效果，现报道如下。
1 资料与方法
1.1 一般资料
136例患者均为病理组织学或细胞学确诊的恶性胸腔积液，患者主要临床表现为胸闷、胸痛、气促、呼吸困难等，经胸片、B超或胸部CT检查诊断为中至大量胸腔积液。其中男86例，平均年龄58岁；女50例，平均年龄51岁。收治的136例患者中，肺癌120例，乳腺癌7例，食管癌4例，非霍奇金淋巴瘤3例，卵巢癌2例。所有患者健康状况(Karnovsky)评分均>60分，预计生存时间超过3个月，治疗前患者的血常规和肝、肾功能检查结果均正常 ......
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