【摘要】 目的观察尿激酶联合化疗药物对恶性多房性胸腔积液的临床疗效。方法收集66例伴恶性多房性胸腔积液的患者,随机分为两组,治疗组(n=32)胸腔内注入尿激酶25万单位,可反复多次,至胸腔积液排空,腔内注入顺铂。对照组(n=34)引流胸腔积液后直接将顺铂注入胸腔。比较两组患者胸腔积液控制效果、肺复张情况并观察不良反应。结果治疗组87.5%的患者达到肺复张,对照组为47.1%,组间差异显著(P<0.05)。治疗组总有效率为84.4%,对照组为58.8%,治疗组显著高于对照组(P<0.05)。治疗组一年生存率(77.8%)显著高于对照组(0%)(P<0.05)。不良反应主要体现在发热、胸疼及胃肠道反应,两组间差异无统计学意义。结论胸腔内注入尿激酶联合化疗药物控制恶性多房性胸腔积液效果显著,副作用可耐受,值得临床推广应用。更多还原

【Abstract】 Objective To observe the curative effect of urokinase combined chemotherapy drugs in the treatment of patients with malignant multilocular pleural effusion. Methods Sixtysix patients with malignant multilocular pleural effusion were randomly divided into two groups.The treatment group( n = 32) was treated with intrapleural injection of 250 000 U urokinase,which can be repeated until pleural effusion was empty. Then cisplatin was injected into thoracic cavity. The control group( n = 34) was directly treated with cisplatin which was injected into thoracic cavity after drainage of pleural effusion. The control effect of pleural effusion and situation of lung reexpansion were compared between the two groups,and the adverse reactions were observed. Results There were 28 cases( 87. 5%) of lung reexpansion in the treatment group and 16 cases( 47. 1%) in the control group( P < 0. 05). Total effective rate of treatment group was 84. 4%,which was significantly higher than 58. 8% in control group( P < 0. 05).One-year survival rate of treatment group( 77. 8%) was significantly higher than that( 0%) of control group( P < 0. 05). Adverse reaction was mainly manifested in the fever,chest pain andgastrointestinal reaction,and there was no statistically significant difference between the two groups. Conclusion Command of malignant multilocular pleural effusion with intrapleural injection of urokinase combined with chemotherapy drugs is obviously effective,and side effects could be tolerated. It is worthy of clinical popularization and application.更多还原