重组人血管内皮抑制素联合顺铂和博来霉素治疗肺癌恶性胸腔积液的效果比较.docVIP

重组人血管内皮抑制素联合顺铂和博来霉素治疗肺癌恶性胸腔积液的效果比较 　　[摘要] 目的 观察重组人血管内皮抑制素联合顺铂和博来霉素治疗肺癌恶性胸腔积液的近期效果及安全性。 方法 2011年10月～2013年10月，将73例肺癌伴恶性胸腔积液的患者经胸腔内置中心静脉导管排尽积液后随机分为A、B组。A组37例给予胸腔内灌注重组人血管内皮抑制素30 mg+顺铂40 mg；B组36例给予胸腔内灌注重组人血管内皮抑制素30 mg+博来霉素粉针60 mg，两组均每周给药1次，连续给药3周。评价两组患者胸腔积液减少量的近期疗效、Karnofsky体力状况评分、不良反应发生率及生存率。 结果 胸腔积液减少量的近期疗效：A组的总有效率为72.97%，B组为88.89%，两组比较，差异无统计学意义（χ2=2.98，P0.05）。A组的KPS体力状况评分改善率为37.84%，B组为61.11%，两组比较，差异有统计学意义（χ2=3.87，P0.05）。两组的6个月生存率（A组为86.49%，B组为94.44%）差异无统计学意义（χ2=0.57，P0.05），1年生存率（A组为54.05%，B组为77.78%）差异有统计学意义（χ2=4.56，P0.05）。 结论 重组人血管内皮抑制素联合顺铂和博来霉素治疗肺癌恶性胸腔积液均具有较好的效果，且不良反应少。 　　[关键词] 重组人血管内皮抑制素；顺铂；博来霉素；恶性胸腔积液 　　[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-4721（2015）07（b）-0118-04 　　[Abstract] Objective To observe the short-term curative effect and safety of recombinant human endostatin combined with cisplatin and bleomycin in the treatment of malignant pleural effusion induced by lung cancer. Methods From October 2010 to October 2013，73 patients with lung cancer complicated with malignant pleural effusion were randomly divided into group A and group B after complete discharge of effusion by implanting central venous catheter in thoracic cavity.37 patients in group A were given pleural infusion of 30 mg recombinant human endostatin+40 mg of cisplatin while 36 patients in group B were given pleural infusion of 30 mg of recombinant human endostatin+60 mg of bleomycin injection.The drug was administered once a week for continuous 3 weeks.Short-term curative effect of decreased volume of pleural effusion，Karnofsky performance score，the incidence rate of adverse reaction and survival rate was assessed between two groups of patients. Results Short-term curative effect of decreased volume of pleural effusion：total effective rate in group A was 72.97%，while it was 88.89% in group B，and there was no statistical difference between two groups （χ2=2.98，P0.05）.The improvement rate of KPS physical condition score was 37.84% in group A，while it was 61.11%，in group B，and there was a statist