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目的比较胸腔镜胸膜固定术与闭式引流术治疗恶性胸腔积液(MPE)的临床效果。方法选取南京市溧水区人民医院胸外科2014年收治的MPE患者112例,根据随机数字表法分为胸腔镜组与闭式引流组,各56例。胸腔镜组患者行胸腔镜胸膜固定术,闭式引流组患者行胸腔闭式引流术。比较两组患者的临床效果,平均引流时间及治疗前后KPS评分,并比较两组患者1、2年生存率。结果胸腔镜组患者MPE控制情况优于闭式引流组(P<0.05)。胸腔镜组患者平均引流时间短于闭式引流组(P<0.05)。治疗前,两组患者KPS评分比较,差异无统计学意义(P>0.05);治疗后,胸腔镜组患者KPS评分高于闭式引流组(P<0.05)。随访至2016年6月,两组患者1年生存率比较,差异无统计学意义(P>0.05),胸腔镜组患者2年生存率高于闭式引流组(P<0.05)。结论胸腔镜胸膜固定术治疗MPE疗效优于闭式引流术,可快速有效控制MPE,延长患者生存期,改善患者生活质量。
Objective To compare the clinical effects of thoracoscopic pleurodesis and closed drainage in the treatment of malignant pleural effusion (MPE). Methods One hundred and twelve patients with MPE who underwent thoracic surgery in People ’s Hospital of Lishui District of Nanjing in 2014 were divided into thoracoscope group and closed drainage group according to the random number table method, each with 56 cases. Thoracoscopic pleurodesis patients underwent pleurodesis, closed drainage group underwent closed thoracic drainage. The clinical effects, mean drainage time, and KPS scores before and after treatment were compared between the two groups. The 1-year and 2-year survival rates were compared between the two groups. Results The MPE control in thoracoscopic group was better than that in closed drainage group (P <0.05). The average drainage time in thoracoscopic group was shorter than that in closed drainage group (P <0.05). Before treatment, there was no significant difference in KPS score between the two groups (P> 0.05). After treatment, KPS score of thoracoscopic group was higher than that of closed drainage group (P <0.05). The follow-up to June 2016 showed no significant difference in 1-year survival between the two groups (P> 0.05). The 2-year survival rate of patients in thoracoscopic group was significantly higher than that in closed drainage group (P <0.05). Conclusions Thoracoscopic pleurodesis is more effective than closed drainage in the treatment of MPE. MPE can be rapidly and effectively controlled to prolong survival and improve patient quality of life.