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目的研究全身化疗结合胸腔置管持续引流并灌注平阳霉素治疗恶性胸腔积液的临床效果,探讨治疗恶性胸腔积液的有效方法。方法常规消毒、铺巾及局麻后,胸穿置入硅胶管,并固定保留,接闭式引流袋,通过输液调节器调控引流速度。当胸腔积液引流彻底时向胸腔内注入地塞米松10mg、利多卡因100mg、平阳霉素8mg,嘱患者多翻身、变换体位。每3周1次,共2次。另配合全身化疗2个疗程。观察胸腔积液消退情况及毒副反应。结果48例中完全缓解(CR)22例,部分缓解(PR)17例,无变化(NC)9例,总有效(CR+PR)率81.3%,其中CR率45.8%。不良反应有胸痛、发热、恶心、呕吐及骨髓毒性。结论胸腔置管引流并腔内灌注平阳霉素是治疗恶性胸腔积液的有效方法,胸腔置管引流较传统胸腔穿刺抽液或胸腔闭式引流具有明显的优势。
Objective To study the clinical effect of systemic chemotherapy combined with continuous drainage of pleural catheter and perfusion of pingyangmycin in the treatment of malignant pleural effusion, and to explore an effective method for the treatment of malignant pleural effusion. Methods After routine disinfection, drape and local anesthesia, the thoracentesis was placed in the silicone tube and fixedly retained, then the drainage bag was closed, and the drainage speed was controlled by the infusion regulator. When the drainage of pleural effusion thoroughly to the intrathoracic injection of dexamethasone 10mg, lidocaine 100mg, Pingyangmycin 8mg, Zhu Huanzhe more stand, change position. 1 every 3 weeks for a total of 2 times. The other with systemic chemotherapy 2 courses. Observation of pleural effusion subsided and toxic side effects. Results In 48 cases, there were 22 cases of complete remission (CR), 17 cases of partial remission (PR) and 9 cases of no change (NC). The total effective rate was 81.3%. The CR rate was 45.8%. Adverse reactions are chest pain, fever, nausea, vomiting and myelotoxicity. Conclusions Pleural catheter drainage and intrapleural injection of pingyangmycin is an effective method for the treatment of malignant pleural effusion. Thoracic tube drainage has obvious advantages over traditional thoracentesis or pleural closure drainage.