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目的评价热化综合治疗恶性胸腔积液(malignant pleural effusion,MPE)的疗效、毒副反应及对生活质量的影响。方法101例病人均是经过手术、放射治疗和/或多程化疗后复发及广泛转移的患者;先行穿刺引流并以单药或二联化疗药物行腔内注射,腔内化疗1～6次,平均3次;患者一般情况改善后行全身化疗,根据不同病种选择不同用药方案;每次腔内及静脉化疗后即行射频透热,2次/周,平均6次,腔内温度控制在42℃左右并维持40～60min。结果101例胸水患者中CR54例,PR36例,有效率89.1%;不同病种有效率不同,以乳腺、肺、卵巢及胃肠道肿瘤并积液者疗效较好。治疗后Karn of sky评分80～100组由0%上升到26.7%,60～70组由21.8%上升到治疗后的41.6%,0～30组治疗前后无明显变化。与热疗相关的主要副反应为局部皮肤疼痛(17%)和皮下脂肪硬结(11%)。结论热化综合治疗恶性胸腔积液有较好疗效,并可明显改善患者生活质量,毒副反应可耐受。
Objective To evaluate the curative effect, side effects and quality of life of patients with malignant pleural effusion (MPE) combined with heating therapy. Methods The 101 patients were all patients who had undergone surgery, radiation therapy and / or multi-course chemotherapy for recurrence and extensive metastasis. The patients underwent first puncture and drainage and intracavitary injection of single or dual chemotherapy drugs, intracavitary chemotherapy 1 to 6 times, mean 3 times. The general condition of the patients was followed by systemic chemotherapy. Different dosage regimens were chosen according to different disease types. Radiofrequency diathermy was given after intracavitary and intravenous chemotherapy twice a week for an average of 6 times. The intraluminal temperature was controlled at 42 ° C Left and right and maintain 40 ~ 60min. Results 101 cases of pleural effusion in CR54 cases, PR36 cases, the effective rate of 89.1%; different diseases with different efficiency to breast, lung, ovarian and gastrointestinal tumors and effusion were better. After treatment, Karn of sky score increased from 0% to 26.7% in 80 ~ 100 group and from 21.8% to 41.6% in 60 ~ 70 group after treatment, while there was no significant change in 0 ~ 30 group before and after treatment. The main side effects associated with hyperthermia are local skin pain (17%) and subcutaneous fat induration (11%). Conclusion Heating comprehensive treatment of malignant pleural effusion has a good effect, and can significantly improve the quality of life of patients, toxicity can be tolerated.