艾迪注射液联合博来霉素治疗恶性胸腔积液的效果观察

摘要

目的 观察艾迪注射液联合博来霉素治疗恶性胸腔积液的临床疗效.方法 将90例恶性胸腔积液患者完全随机分为观察组和对照组,各45例,2组患者均采用胸腔放置引流管放净胸腔积液.对照组每次胸腔内注射博来霉素45 ～ 60 mg+0.9％氯化钠注射液40 ml+地塞米松5 mg+利多卡因注射液5 ml;观察组患者在对照组基础上加注艾迪注射液50 ml,1周后重复胸腔内注入,持续3周.治疗4周后,观察和比较2组的临床疗效、不良反应发生率和一般生活状况评分(KPS评分).结果 治疗4周后,观察组有效率[86.7％ (39/45)]明显高于对照组[55.6％(25/45)],KPS评分[(79±6)分]明显高于对照组[(73±6)分],患者生活质量改善率[75.6％(34/45)]明显高于对照组[42.2％ (19/45)],差异均有统计学意义(均P＜0.05).观察组不良反应发生率[22.2％ (10/45)]明显低于对照组[68.9％ (31/45)],差异有统计学意义(P＜0.05).结论 艾迪注射液联合博来霉素治疗恶性胸腔积液较单用博来霉素的近期疗效及生活质量均明显提高,不良反应发生率明显降低.%Objective To investigate the effect of Addie injection combined with bleomycin in treatment of malignant pleural effusion.Methods Ninety patients of malignant pleural effusion were randomly divided into observation group (45 cases) and control group (45 cases).In all the cases,the pleural effusion was drained by tube thorax.The patients in control group received intrathoracic injection of bleomycin (45-60 mg) +0.9％ sodium chloride + dexamethasone (5 mg) + lidocaine (5 ml) group,the patients in observation group additionally received intrathoracic injection of Addie (50 ml),1 time per week.Four weeks after treatment,the clinical effect,incidence of adverse reactions and Karnofsky performance score (KPS) were evaluated and compared between the two groups.Results After 4 weeks of treatment,the effective rate in observation group reached to 86.7％ (39/ 45),being significantly higher than that in control group 55.6％ (25/45) (P ＜ 0.05);the KPS score and improvement rate of life quality in observation group after treatment were both significantly higher than that in control group [(79 ± 6) scores vs (73 ± 6) scores,75.6％ (34/45) vs 42.2％ (19/45)] (P ＜ 0.05).The incidence of adverse reactions in observation group was significantly lower than that in control group [22.2％ (10/45) vs 68.9％ (31/45)],(P ＜ 0.05).Conclusion Addie injection combined with bleomycin can significantly improve the short-term effect and quality of life with lower incidence of adverse reactions compared with single use of bleomycin in patients of malignant pleural effusion.