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目的探讨腔内注入法治疗肺癌恶性胸腔积液疗效和不良反应。方法选取2010年2月至2013年1月间湖北省恩施州中心医院中西医结合肿瘤科收治的51例患者。术前排净胸积液后,分别注入顺铂(顺铂组,17例)、卡铂(卡铂组,17例)和紫杉醇脂质体(紫杉醇脂质体组,17例)治疗胸腔积液。分析3组患者的疗效和不良反应。结果 3组患者的治疗总有效率组间差异无统计学意义(P>0.05)。卡铂组患者完全缓解率为47.1%,顺铂组为11.8%,两组间差异有统计学意义(P<0.05);紫杉醇脂质体组与卡铂组和顺铂组比较,差异均无统计意义(均P<0.05)。治疗后3组患者的生活质量评分与治疗前比较,差异均有统计学意义(P<0.01)。患者的不良反应均较轻,其中卡铂组患者各种不良反应发生率为11.8%,显著低于顺铂组和紫杉醇脂质体组(均P<0.05)。结论3种药物均可有效地治疗肺癌恶性胸腔积液,其中卡铂的完全缓解率较高,生活质量评分显著提高,并且不良反应较轻,发生率较低。
Objective To investigate the efficacy and adverse reactions of intraluminal injection in the treatment of malignant pleural effusion of lung cancer. Methods Totally 51 patients admitted from Integrative Medicine Department of Enshi Central Hospital of Hubei Province from February 2010 to January 2013 were enrolled. Preoperative drainage of pleural effusion, were injected cisplatin (cisplatin group, 17 cases), carboplatin (carboplatin group, 17 cases) and paclitaxel liposomes (paclitaxel liposome group, 17 cases) treatment of pleural effusion liquid. The efficacy and adverse reactions of the three groups were analyzed. Results There was no significant difference in the total effective rate between the three groups (P> 0.05). The complete remission rate was 47.1% in carboplatin group and 11.8% in cisplatin group, there was a significant difference between the two groups (P <0.05). There was no difference between paclitaxel liposome group and carboplatin group and cisplatin group Statistical significance (all P <0.05). The quality of life scores of three groups after treatment were significantly different from those before treatment (P <0.01). Adverse reactions were mild in all patients. The incidence of adverse reactions in carboplatin group was 11.8%, which was significantly lower than that in cisplatin group and paclitaxel liposome group (all P <0.05). Conclusions All the three drugs can effectively treat malignant pleural effusion of lung cancer. The complete remission rate of carboplatin is higher, the quality of life score is significantly improved, and the side effects are less and the incidence rate is lower.