周来勇?刘芳?倪峰?王爱琴?张福伟

[摘要] 目的 探讨胸腔内注入沙培林治疗晚期肺癌恶性胸腔积液的方法和疗效。 方法 收集晚期肺癌合并胸腔积液患者40例，采用中心静脉导管行胸腔置管引流，胸水引流完全后，将观察组（n=20）胸腔内注入沙培林治疗，对照组（n=20）注入顺铂治疗，观察两组不良反应及治疗效果。 结果 观察组有效率85%（17/20），对照组有效率65%（13/20），两组间有显著性差异（P<0.05），观察组主要不良反应为发热、胸痛，对照组在骨髓抑制、消化道不适反应及肝肾功能影响方面明显。结论 沙培林治疗晚期肺癌胸腔积液效果确切，不良反应较轻，患者耐受性好，值得临床推广。

[关键词] 沙培林；顺铂；胸腔积液；肺癌

[中图分类号] R734.2 [文献标识码] A [文章编号] 2095-0616（2017）14-200-03

Curative effect of Sapylin in treatment of advanced lung cancer pleural effusion

ZHOU Laiyong1 LIU Fang1 NI Feng1 WANG Aiqin1 ZHANG Fuwei2

1.Cardiothoracic Surgery，Shenzhen Baoan Hospital Affiliated to Southern Medical University，Shenzhen 518101，China；2.Cardiothoracic Surgery，Zhujiang Hospital affiliated to Southern Medical University，Guangzhou 510282，China

[Abstract] Objective To explore the method and curative efect of intrapleural injection of Sapylin in the treatment of advanced lung cancer with malignant pleural effusion. Methods 40 cases of advanced lung cancer complicated with pleural effusion were gathered.Thoracic drainage was performed by central venous catheter.After complete drainage of pleural effusion，patients in obervation group（n=20） were treated with intrapleural injection of sapylin，and patients in control group were treated with cisplatin.Adverse reactions and treatment effects of the two groups were observed. Results The effective rate of the observation group was 85%（17/20），and the effective rate of the control group was 65%（13/20），there were significant differences between the two groups（P<0.05）.The main adverse reactions in the observation group were fever and chest pain，and the control group had obvious effects on myelosuppression，gastrointestinal upset reaction and liver and kidney function. Conclusion The curative effect of Sapylin in treatment of advanced lung cancer pleural effusion is exact.Adverse reactions are mild，and the patient is well tolerated.It is worthy of clinical promotion.

[Key words] Sapylin；Cisplatin；Pleural effusion；Lung cancer

恶性胸腔积液（malignant pleural effusion，MPE）是由于胸膜肿瘤或肿瘤转移所致，晚期肺癌是引发该病的最常见原因[1]。大量胸腔积液会直接影响循环呼吸功能，严重影响患者生活质量和生存期。目前临床治疗胸腔积液主要采用局部注药的方式，其可有效缓解积液症状。本次研究收集40例晚期肺癌合并胸腔积液患者进行观察分析，随机分为两组后，分别采用沙培林和顺铂行胸腔内注射治疗。现报道如下。

1 资料与方法

1.1 一般資料

采用随机数字表法将2014年11月～2016年11月于我院接受治疗的晚期肺癌合并胸腔积液患者40例分为两组。其中观察组沙培林治疗组（n=20例），男14例，女6例，年龄35～76岁，平均（54.3±4.8）岁，鳞癌6例，腺癌13例，鳞腺癌1 例。对照组顺铂治疗组（n=20例），男13例，女7例，年龄32～78岁，平均（56.4±5.1）岁，鳞癌5例，腺癌13例，大细胞癌1例，鳞腺癌1例。入选标准：经影像学以及病理细胞组织检查确诊为非小细胞肺癌；经胸部CT、X线、B超检查存在大量胸腔积液。排除标准：伴有严重心、肝、肾疾病；KPS评分≤50分；预计生存期≤3个月。……