中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
13期
11-13
,共3页
心包置管引流%肺癌%恶性心包积液
心包置管引流%肺癌%噁性心包積液
심포치관인류%폐암%악성심포적액
Drainage catheter by pericardiocentesis%Lung cancer%Malignant pericardial effusion
目的 探讨不同心包内置管引流时间对肺癌伴恶性心包积液心包填塞的临床疗效和安全性.方法 将入选的88例患者随机分为A、B两组.A组44例,为长时间置管组,置管时间为＞4周;B组44例,为短期置管组,置管时间＜4周.两组患者均接受相同的心包注射和全身静脉注射药物治疗方案,分别观察6个月内的疗效、生存时间、复发率、生存率及置管并发症发生率.结果 A、B两组近期完全缓解率(54.55% vs 36.36%,χ2＝2.93,P=0.09)和部分缓解率(36.36% vs 34.91%,χ2＝0.90,P=0.87)差异均无统计学意义,但总有效率比较差异有统计学意义(90.91% vs 70.45%,χ2＝5.91,P=0.02),OR=4.19,95%CI:1.24~14.13.半年内的复发率A、B两组分别为20.45% 和38.63%(χ2＝3.91,P=0.04).A、B两组中位生存时间分别为7.96、3.52个月,生存率分别为72.47% 和51.38%(Log rank＝4.76,P=0.04).两组患者穿刺部位化脓感染发生率分别为4.55%和2.77%(χ2=0.34,P＞0.05).两组患者均未发现心包化脓感染、窦道形成及严重粘连等并发症.结论 适当延长心包置管引流时间,可提高治疗效果,安全性高,可作为肺癌心包积液的首要治疗方法.
目的 探討不同心包內置管引流時間對肺癌伴噁性心包積液心包填塞的臨床療效和安全性.方法 將入選的88例患者隨機分為A、B兩組.A組44例,為長時間置管組,置管時間為＞4週;B組44例,為短期置管組,置管時間＜4週.兩組患者均接受相同的心包註射和全身靜脈註射藥物治療方案,分彆觀察6箇月內的療效、生存時間、複髮率、生存率及置管併髮癥髮生率.結果 A、B兩組近期完全緩解率(54.55% vs 36.36%,χ2＝2.93,P=0.09)和部分緩解率(36.36% vs 34.91%,χ2＝0.90,P=0.87)差異均無統計學意義,但總有效率比較差異有統計學意義(90.91% vs 70.45%,χ2＝5.91,P=0.02),OR=4.19,95%CI:1.24~14.13.半年內的複髮率A、B兩組分彆為20.45% 和38.63%(χ2＝3.91,P=0.04).A、B兩組中位生存時間分彆為7.96、3.52箇月,生存率分彆為72.47% 和51.38%(Log rank＝4.76,P=0.04).兩組患者穿刺部位化膿感染髮生率分彆為4.55%和2.77%(χ2=0.34,P＞0.05).兩組患者均未髮現心包化膿感染、竇道形成及嚴重粘連等併髮癥.結論 適噹延長心包置管引流時間,可提高治療效果,安全性高,可作為肺癌心包積液的首要治療方法.
목적 탐토불동심포내치관인류시간대폐암반악성심포적액심포전새적림상료효화안전성.방법 장입선적88례환자수궤분위A、B량조.A조44례,위장시간치관조,치관시간위＞4주;B조44례,위단기치관조,치관시간＜4주.량조환자균접수상동적심포주사화전신정맥주사약물치료방안,분별관찰6개월내적료효、생존시간、복발솔、생존솔급치관병발증발생솔.결과 A、B량조근기완전완해솔(54.55% vs 36.36%,χ2＝2.93,P=0.09)화부분완해솔(36.36% vs 34.91%,χ2＝0.90,P=0.87)차이균무통계학의의,단총유효솔비교차이유통계학의의(90.91% vs 70.45%,χ2＝5.91,P=0.02),OR=4.19,95%CI:1.24~14.13.반년내적복발솔A、B량조분별위20.45% 화38.63%(χ2＝3.91,P=0.04).A、B량조중위생존시간분별위7.96、3.52개월,생존솔분별위72.47% 화51.38%(Log rank＝4.76,P=0.04).량조환자천자부위화농감염발생솔분별위4.55%화2.77%(χ2=0.34,P＞0.05).량조환자균미발현심포화농감염、두도형성급엄중점련등병발증.결론 괄당연장심포치관인류시간,가제고치료효과,안전성고,가작위폐암심포적액적수요치료방법.
Objective To evaluate the early effects and safety of prolonged implanted catheter in pericardium on the patients with lung cancer and pericardial transmission. Methods Eighty-eight cases enrolled were randomly devided into two groups(group A and group B),the period of implanted catheter was more than four weeks in group A and less than four weeks in group B. The treatment protocal of the two groups was the same, then to observe the outcome, survival time of patients, the recurrence rate of pericardial effusion, the complications relevant to the catheter. Results The early complete relief rate (CRR) of two groups(A and B) was of no statistical significance (χ2＝2.93,P=0.09), but the total effective rate of two groups had a significant statistical difference(90.91% vs 70.45%,χ2=5.91,P=0.02), OR=4.19, 95%CI(confidence interval):1.24-14.13. The recurrence rate of two groups within half a year was 20.45% vs 38.63%,χ2=3.91,P=0.04,the survival rate of group A and group B was 72.47% and 51.38%(Log rank=4.76,P=0.04).The median survival period of two groups within half a year was 7.96 months and 3.52 months. There were no difference in complication(4.55% vs 2.77%,χ2=0.34,P＞0.05),and there were not pyogenic infection in pericardium, fistula formation, penicarditis severe pericardiosymphysis and myocardial injury. Conclusions The moderate prolonged time of catheter drainage treatment is an effective and safe approach for lung cancer patients with pericardial transmission, it can be the main treatment.
