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目的探讨胸腔内注射重组人腺病毒(r Ad-p53)对肺癌恶性胸腔积液的疗效。方法 36例伴有恶性胸腔积液的肺癌患者随机分为2组,采用胸腔内注射r Ad-p53联合静脉输注奈达铂治疗为观察组(n=20),采用单纯静脉输注奈达铂治疗为对照组(n=16)。比较2种方案的胸腔积液的控制有效率,并检测最大自主通气量(MVV)和Kamofsky评分(KPS),比较2组治疗前后的肺功能和生活质量的改变。结果观察组胸腔积液有效控制率85%(17/20)高于对照组50%(8/16),差异显著(P<0.05)。观察组治疗后KPS≥80分者由25%(5/20)上升至55%(11/20),P<0.05;对照组治疗前后差异不明显,P>0.05。结论胸腔内注射r Ad-p53联合化疗更能有效控制肺癌恶性胸腔积液的产生,并提高患者生活质量。
Objective To investigate the effect of intra-thoracic injection of recombinant human adenovirus (r Ad-p53) on malignant pleural effusion in lung cancer. Methods Thirty-six patients with lung cancer with malignant pleural effusion were randomly divided into two groups. The patients were treated with intra-thoracic injection of Ad-p53 combined with intravenous infusion of nedaplatin (n = 20) Platinum treatment was the control group (n = 16). The control efficiency of pleural effusion was compared between the two regimens. The maximum voluntary ventilation (MVV) and the Kamofsky score (KPS) were also measured. The changes of pulmonary function and quality of life before and after treatment were compared. Results The effective control rate of pleural effusion in observation group was 85% (17/20) higher than that in control group (8/16) (P <0.05). The observation group after treatment KPS ≥ 80 points from 25% (5/20) increased to 55% (11/20), P <0.05; control group before and after treatment was not significantly different, P> 0.05. Conclusion Thoracic injection of Ad-p53 combined with chemotherapy can effectively control the production of malignant pleural effusion in lung cancer and improve the quality of life of patients.