亚砷酸胸腔灌注联合体外高频热疗治疗癌性胸水.docVIP

　　亚砷酸胸腔灌注联合体外高频热疗治疗癌性胸水 作者：邓宏，周宇姝， 吴万垠，龙顺钦，郑剑霄， 柴小姝，薛晓光，河文峰， 蔡姣芝，张海波，孙良生 【摘要】 目的观察亚砷酸胸腔内灌注联合体外高频热疗对癌性胸水的疗效。方法连续纳入45例癌性胸水病例，采用抽签法分为A、B、C 3组。所有患者均尽量引流胸水（至引流量小于150 ml/d），A组经导管向胸腔内灌注亚砷酸20 mg，后拔除导管并于当日行胸腔局部热疗1次，以后隔日热疗1次，连续4次；B组仅予胸腔内灌注亚砷酸20 mg并拔除导管；C组于胸水引净后拔除导管，并于当日行胸腔局部热疗1次，以后隔日热疗1次，连续4次。在拔管4周后复查胸水量，观察3种方法对癌性胸水的疗效及毒性反应。结果 治疗 后A、B、C 3组有效率分别为86.7%，62.5%和50.0%，A组胸水疗效优于B组和C组（P＜0.05）。治疗后3组胸水LDH均较各组治疗前升高，均有显著性差异 (P＜0.01,P＜0.05)，以A、B两组胸水LDH升高明显。治疗后A、B两组胸水CEA均较各组治疗前降低，均有显著性差异 (P＜0.01)，以A组胸水CEA下降明显。治疗后3组患者均未出现血液学、心脏、肝脏、肾脏等毒性反应。结论亚砷酸胸腔内灌注联合体外高频热疗控制癌性胸水具有协同增效作用，毒副反应小，患者易于耐受。 【关键词】 恶性胸腔积液； 亚砷酸； 体外高频热疗； 胸腔内灌注 　　Abstract:ObjectiveTo observe the efficacy of extracorporeal high-frequency hyperthermia bined alignant pleural effusion．MethodsForty-five patients alignant pleural effusion s by ballot：A,B and C. After the accumulation of pleural fluid had been adequately drained，Arm A recEived pleural cavity infusion of Arsenic Trioxide 20mg folloia once every tes. In Arm B, all patients g. In Arm C, patients ia once every tes. The efficacy of pleural effusion and toxic reactions s（P＜0.05）. The levels of LDH in pleural effusion of post-treatment in three arms ent. And there ent and post-treatment（P＜0.05,P＜0.01）. Those of Arm A and Arm B increased significantly. The levels of CEA in pleural effusion of post-treatment in Arm A and Arm B ent. And there ent and post-treatment（P＜0.01）. Those of Arm A reduced significantly. All the patients had no blood, heart, liver, kidney and other toxic reactions.ConclusionThe efficacy to malignant pleural effusion of extracorporeal high-frequency hyperthermia bined ethod of pleural cavity infusion of Arsenic Trioxide and high-frequency hyperthermia. The first method has bined synergies. The treatment is ia； Pleural Infusion 　　恶性胸水是癌症晚期常见的并发症之一, 常导致呼吸、循环功能的障碍，产生呼吸困难、咳嗽、胸痛、胸闷等呼吸及循环障碍症状，极大地影响了患者的生存质量和生存期。积极有效地控制恶性胸腔积液就能减轻患者的痛苦，提高生活质量，延长生存期，因此如何更加有效地控制癌性胸水是肿瘤科医生面临的一个重要课题。笔者采用胸腔内灌注亚砷酸联合体外高频热疗的方法治疗癌性胸水,取得较满意疗效。现将结果报道如下。 　 　1 临床资料 　　1.1 纳入标准必须同时符合以下条件：