【摘要】 目的比较奈达铂与顺铂腔内灌注治疗恶性胸腹水的临床疗效。方法选择2010年1月至2014年2月在河北省唐山市人民医院治疗的恶性胸腹水患者73例,根据随机数表法分为观察组(n=37)和对照组(n=36)。观察组患者采用40 m L生理盐水、50 mg奈达铂和5 mg地塞米松治疗;对照组给药方案为40 m L生理盐水、40 mg顺铂和5 mg地塞米松,两组患者均进行2个月的治疗。治疗2个月后对两组患者胸腹水缓解情况、生存质量、生存率以及不良反应发生情况进行评估。结果治疗后,观察组患者的腹水缓解率为83.8%(31/37),明显高于对照组的58.3%(21/36),差异有统计学意义(P<0.05),观察组患者生理功能、生理职能、情感职能、躯体疼痛、社会功能、精神健康、活力和总体健康等生存质量维度得分均显著高于对照组,差异均有统计学意义(P<0.05);观察组患者24个月生存率为51.3%(19/37),明显高于对照组的22.2%(8/36),差异有统计学意义(P<0.05)。观察组患者消化道症状,胸痛发生率分别为58.3%(21/36),19.4%(7/36),显著低于对照组32.4%(12/37)和2.7%(1/37),差异显著(P<0.05);结论与顺铂相比,奈达铂对恶性胸腹水具有更好的临床疗效,且其不良反应发生率较低,能够显著延长患者生存期,可在临床推广应用。更多还原

【Abstract】 Objective To compare the clinical efficacy of nedaplatin and cisplatin intracavitary perfusion in the treatment of malignant pleural effusion and ascites. Methods A total of 73 cases of patients with malignant pleural effusion and ascites, who admitted to People’s Hospital of Tangshan from January 2010 to February 2014, were selected and randomly divided into the observation group(n=37) and the control group(n=36) according to the random number table.The patients in the observation group received 40 m L normal saline, 50 mg nedaplatin and 5 mg dexamethasone, and the control group administered with saline solution for 40 m L, 40 mg cisplatin and 5 mg dexamethasone. The treatment time of two groups of patients was two months. After 2 months normal saline treatment, the ascites remission, quality of life,survival rate and incidence of adverse reactions in two groups were evaluated. Results After treatment, the remission rate of ascites in observation group was 50%(21/36), which was significantly higher than 31%(31/37) in the control group(P<0.05). The physiological function, physiological function, body pain, emotional function, social function, mental health, vitality and general health and quality of life scores in the observation group were significantly higher than those of the control group(P<0.05). The 24-month survival rate in observation group was 51.3%(19/37), which was significantly higher than 22.2%(8/36) of the control group(P<0.05). The incidence of gastrointestinal symptoms and chest pain in the observation group were 58.3%(21/36) and 19.4%(7/36), which were significantly lower than 32.4%(12/37)and 2.7%(1/37) in the control group(P<0.05). Conclusion Compared with cisplatin, nedaplatin has better clinical efficacy in treating malignant pleural effusions, and the incidence of adverse reactions was low. Nedaplatin can significantly prolong the survival time of the patients, and can be applied in clinical practice.更多还原