目的:探讨斑蝥酸钠维生素B_6联合顺铂和白介素-2(IL-2)胸腔内热灌注治疗肺癌恶性胸腔积液的疗效和安全性。方法:70例确诊肺癌并首次出现胸腔积液的患者随机分为试验组和对照组各35例,均行胸腔置中心静脉管闭式引流,排尽胸腔积液。此后试验组胸腔内热灌注斑蝥酸钠维生素B_6注射液、顺铂及IL-2;对照组胸腔内普通灌注顺铂及IL-2。两组均每周治疗1次,共治疗4周。比较两组患者的疗效、生活质量(KPS评分)、药品不良反应和胸腔积液复发情况。结果:试验组有效率为82.5%,显著高于对照组(P<0.01)。两组患者治疗后KPS评分均较前显著提高(P<0.05),但组间差异无统计学意义(P>0.05)。两组药品不良反应差异无统计学意义(P>0.05)。试验组患者胸腔积液近期复发率降低,且复发时间显著推迟(P<0.05)。结论:与传统胸腔灌注化疗比较,斑蝥酸钠维生素B_6注射液、顺铂及IL-2联合经胸腔热灌注治疗肺癌恶性胸腔积液疗效较好,能改善患者生存质量,不良反应无明显增加,值得临床推广。 Objective: To investigate the efficacy and safety of sodium cantharidate vitamin B 6 combined with intrapleural perfusion of cisplatin and interleukin-2 (IL-2) in the treatment of malignant pleural effusion of lung cancer. Methods: Seventy patients diagnosed with lung cancer with pleural effusion for the first time were randomly divided into test group (35 cases) and control group (35 cases). All patients underwent closed drainage with thoracic central venous catheter to drain pleural effusion. The experimental group after intrathoracic hot perfusion cantharidin vitamin B_6 injection, cisplatin and IL-2; control group intrathoracic normal infusion of cisplatin and IL-2. Two groups were treated once a week for a total of 4 weeks. Efficacy, quality of life (KPS score), adverse drug reactions and recurrence of pleural effusion were compared between the two groups. Results: The effective rate of the experimental group was 82.5%, which was significantly higher than that of the control group (P <0.01). KPS scores of both groups were significantly increased after treatment (P <0.05), but there was no significant difference between the two groups (P> 0.05). Adverse reactions between the two groups showed no significant difference (P> 0.05). The recent recurrence rate of pleural effusion in test group patients decreased, and the recurrence time was significantly delayed (P <0.05). CONCLUSION: Compared with traditional pleural perfusion chemotherapy, sodium cantharidinate vitamin B 6 injection, cisplatin and IL-2 combined with intra-thoracic thermal perfusion are effective in treating malignant pleural effusion of lung cancer and can improve the quality of life of patients with no significant increase in adverse reactions. Worth clinical promotion.