中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
21期
9549-9552
,共4页
姜勇%崔林%吴兴军%刘兴祥%周向荣%刘建军%何学军%李阳
薑勇%崔林%吳興軍%劉興祥%週嚮榮%劉建軍%何學軍%李暘
강용%최림%오흥군%류흥상%주향영%류건군%하학군%리양
顺铂%甘露聚糖肽%腔内化疗%热疗%恶性胸腹腔积液
順鉑%甘露聚糖肽%腔內化療%熱療%噁性胸腹腔積液
순박%감로취당태%강내화료%열료%악성흉복강적액
Cisplatin%Mannatide%Intrapleural or intraperitoneal chemotherapy%Hyperthermia%Malignant pleural or peritoneal effusion
目的：观察胸腹腔内温热灌注顺铂联合甘露聚糖肽治疗恶性胸腹腔积液的临床疗效和毒副反应。方法2011年8月至2013年6月，在泰州市第二人民医院肿瘤科住院，经细胞学确诊恶性胸腹腔积液的患者，经超声检查定位后胸腹腔置管，引流毕积液后，予顺铂60 mg和甘露聚糖肽40 mg腔内温热灌注治疗。每周1次，连续3周。治疗结束2周后评价疗效及毒副反应。结果46例患者均完成3次胸腹腔灌注，完全缓解11例（23.9%），部分缓解16例（34.8%），稳定8例（17.4%），进展11例（23.9%）。全组治疗总有效率58.7%，其中恶性胸腔积液组有效率68.0%，恶性腹腔积液组有效率47.6%。全组患者生活质量改善28例（60.9%），稳定9例（19.6%），降低9例（19.6%），总改善率60.9%，其中恶性胸腔积液组改善率72.0%，恶性腹腔积液组改善率52.4%。二组治疗有效率和生活质量改善率的差异均无统计学意义（P＞0.05）。主要毒副反应为恶心呕吐、骨髓抑制。无治疗相关性死亡病例。结论腔内温热灌注顺铂联合甘露聚糖肽治疗恶性胸腹腔积液毒副反应轻，疗效满意，值得进一步深入研究。
目的：觀察胸腹腔內溫熱灌註順鉑聯閤甘露聚糖肽治療噁性胸腹腔積液的臨床療效和毒副反應。方法2011年8月至2013年6月，在泰州市第二人民醫院腫瘤科住院，經細胞學確診噁性胸腹腔積液的患者，經超聲檢查定位後胸腹腔置管，引流畢積液後，予順鉑60 mg和甘露聚糖肽40 mg腔內溫熱灌註治療。每週1次，連續3週。治療結束2週後評價療效及毒副反應。結果46例患者均完成3次胸腹腔灌註，完全緩解11例（23.9%），部分緩解16例（34.8%），穩定8例（17.4%），進展11例（23.9%）。全組治療總有效率58.7%，其中噁性胸腔積液組有效率68.0%，噁性腹腔積液組有效率47.6%。全組患者生活質量改善28例（60.9%），穩定9例（19.6%），降低9例（19.6%），總改善率60.9%，其中噁性胸腔積液組改善率72.0%，噁性腹腔積液組改善率52.4%。二組治療有效率和生活質量改善率的差異均無統計學意義（P＞0.05）。主要毒副反應為噁心嘔吐、骨髓抑製。無治療相關性死亡病例。結論腔內溫熱灌註順鉑聯閤甘露聚糖肽治療噁性胸腹腔積液毒副反應輕，療效滿意，值得進一步深入研究。
목적：관찰흉복강내온열관주순박연합감로취당태치료악성흉복강적액적림상료효화독부반응。방법2011년8월지2013년6월，재태주시제이인민의원종류과주원，경세포학학진악성흉복강적액적환자，경초성검사정위후흉복강치관，인류필적액후，여순박60 mg화감로취당태40 mg강내온열관주치료。매주1차，련속3주。치료결속2주후평개료효급독부반응。결과46례환자균완성3차흉복강관주，완전완해11례（23.9%），부분완해16례（34.8%），은정8례（17.4%），진전11례（23.9%）。전조치료총유효솔58.7%，기중악성흉강적액조유효솔68.0%，악성복강적액조유효솔47.6%。전조환자생활질량개선28례（60.9%），은정9례（19.6%），강저9례（19.6%），총개선솔60.9%，기중악성흉강적액조개선솔72.0%，악성복강적액조개선솔52.4%。이조치료유효솔화생활질량개선솔적차이균무통계학의의（P＞0.05）。주요독부반응위악심구토、골수억제。무치료상관성사망병례。결론강내온열관주순박연합감로취당태치료악성흉복강적액독부반응경，료효만의，치득진일보심입연구。
Objective To evaluate the efficacy and side effects of hyperthermia with intrapleural or intraperitoneal cisplatin and mannatide for treating patients with malignant pleural or peritoneal effusion. Methods From August 2011 to June 2013, patients in the department of oncology of the second people's hospital of Taizhou with cytologically confirmed malignant pleural effusion or ascites were enrolled into this study. They were located by B-ultrasonic wave and given puncturing and inserting catheter. After draining the effusion, all patients were treated by hyperthermia with intrapleural or intraperitoneal cisplatin 60 mg and mannatide 40 mg for once a week. Three weeks were a cycle. The efficacy and side effects were evaluated after 2 weeks.Results Forty-six patients were given hyperthermia with intrapleural or intraperitoneal cisplatin and mannatide for 3 times. Of all patients, 11 patients(23.9%) obtained complete response(CR), 16 patients(34.8%) had partial response(PR), 8 patients(17.4%) got stable disease(SD), 11 patients(23.9%) got disease progression(PD). Total response rate(RR) of all patients was 58.7%, RR of malignant pleural effusion group was 68.0%, RR of malignant peritoneal effusion group was 47.6%. About quality of life(QoL), 28 patients(60.9%) obtained improvement, 9 patients(19.6%) had stabilization, 9 patients(19.6%) got decrease. Total improvement rate of QoL in all patients was 60.9%, improvement rate of malignant pleural effusion group was 72.0%, RR of malignant peritoneal effusion group was 52.4%. No significant difference was found between malignant pleural effusion group and malignant peritoneal effusion group on both RR and improvement rate(P>0.05). Main side effects were nausea, vomiting, and bone marrow suppression. No treatment-related deaths occurred.Conclusion Hyperthermia with intrapleural or intraperitoneal infusion of cisplatin and mannatide is a safe treatment for patients with malignant pleural effusion or ascites, the treatment efficacy is encouraging, and side effects are tolerable. Thus, it's worthy of further study.
