目的:观察胸腔内注射博来霉素治疗恶性胸腔积液的效果和安全性。方法:54例恶性胸腔积液患者随机分为观察组28例和对照组26例,行中心静脉导管置管闭式引流术引流胸腔积液后,观察组胸腔内缓慢注射盐酸博来霉素1 mg/kg+生理盐水40 mL,对照组胸腔内注射白细胞介素-2200万u+生理盐水40 mL。比较2组治疗效果和不良反应。结果:观察组4例胸腔注射药物2次,24例注射药物1次;对照组17例胸腔注射药物2次,9例注射药物1次。治疗1个月后观察组完全缓解16例(57.1%),部分缓解8例(28.6%),总有效率85.7%;对照组完全缓解9例(34.6%),部分缓解9例(34.6%),总有效率69.2%,2组比较差异有统计学意义(P<0.05)。观察组出现发热反应2例,轻度恶心2例;对照组出现发热5例,胸痛4例,恶心、呕吐3例,胸壁肿瘤种植1例,2组不良反应发生率比较差异有统计学意义(P<0.05)。结论:中心静脉导管置管引流后胸腔内注射博来霉素治疗恶性胸腔积液疗效满意,不良反应轻。 Objective: To observe the effect and safety of intrapleural injection of bleomycin in the treatment of malignant pleural effusion. Methods: Fifty-four patients with malignant pleural effusion were randomly divided into observation group (n = 28) and control group (n = 26). After drainage of pleural effusion by catheterization of central venous catheter, the rabbits in observation group were injected slowly with bleomycin hydrochloride 1 mg / kg + saline 40 mL, control group, intrapleural injection of interleukin-22 million u + saline 40 mL. Comparison of two groups of treatment and adverse reactions. Results: In the observation group, 4 cases were injected thoracic cavity twice and 24 cases were injected once. In the control group, 17 cases were injected thoracic cavity twice and 9 cases were injected once. One month after treatment, complete remission was observed in 16 cases (57.1%), partial remission in 8 cases (28.6%), and total effective rate of 85.7% in the observation group. Nine cases (34.6%) in the control group and 9 (34.6% , The total effective rate was 69.2%, the difference between the two groups was statistically significant (P <0.05). In the observation group there were 2 cases of febrile reaction and 2 cases of mild nausea. In the control group, there were 5 cases of fever, 4 cases of chest pain, 3 cases of nausea and vomiting and 1 case of chest wall tumor. The incidence of adverse reactions was statistically significant P <0.05). Conclusion: Central venous catheter drainage after injection of bleomycin intrapleural injection of malignant pleural effusion with satisfactory results, adverse reactions.