胸腔镜下局部肿瘤切除术联合胸膜热烧灼治疗肺癌恶性胸腔积液的疗效观察

摘要

目的：：观察胸腔镜辅助局部肿瘤切除术联合胸膜热烧灼治疗肺癌恶性胸腔积液的临床疗效。方法：将2012年1月—2014年6月收治的150例肺癌合并恶性胸腔积液患者按照治疗方式分为两组，分别采用胸腔镜下局部肿瘤切除术联合胸膜热烧灼治疗(观察组)和引流后化疗(对照组)。比较两组的疗效、肺癌血清标志物水平以及生存率。结果：观察组的总有效率(100%)明显高于对照组(53.1%)，差异有统计学意义(P <0.05)；观察组患者的生存期、1年生存率和2年生存率均高于对照组(P 值均<0.05)；观察组治疗后的肺癌血清标志物水平明显低于治疗前(P 值均<0.05)，而对照组的肺癌血清标志物水平治疗前后，差异无统计学意义(P 值均>0.05)。结论：胸腔镜下局部肿瘤切除术联合胸膜热烧灼法治疗肺癌恶性胸腔积液的疗效显著，值得推广。%Objective:To observe the clinical effect of thoracoscopy-assisted local tumor resection combined with pleural ther-mal cautery to treat lung cancer patients with malignant pleural effusion.Methods:One hundred and fifity cases of lung cancer with malignant pleural effusion were collected from January 2012 to June 2014,and divided into two groups.The patients of observation group accepted thoracoscopy-assisted local tumor resection combined with pleural thermal ablation treatment and chemotherapy.Other patients of control group accepted chemotherapy after drainage treatment.The curative effect,the level of serum markers of lung cancer and survival rate were compared in two groups.Results:The total effective rate of observation group (100%)was significantly higher than that of control group (53.1 %),P <0.05.The survival time and 1-year survival rate and two-year survival rate in the observation group were higher than those in the control group (all P <0.05).The levels of lung cancer serum biomarkers in observation group after treatment were significantly lower than those before treatment (both P <0.05 ),while the levels of lung cancer serum markers in control patients after treatment were not significantly different from those before treatment (both P >0.05).Conclusions:The clinical effect of thoracoscopy-assisted local tumor resection combined with pleural thermal ablation in the treatment of malignant pleural effusion of lung cancer is notable and worthy of clinical promoting.