摘要
目的探讨重组人血管内皮抑素(恩度)心包腔内灌注联合全身化疗治疗恶性心包积液的有效性和安全性。方法大量恶性心包积液的患者7例,置细管引流,在尽可能排出积液后,心包腔内给予恩度单药30～45 mg,封管和保留药物。3～5 d后开放导管,若无液体流出,且B超检查证实无积液时,可以拔除导管;若心包内仍有积液,则需继续引流和重复以上药物治疗;最多用药6次。同时结合患者具体病情,应用全身化疗。参照WHO制订的浆膜腔积液疗效评价标准及实体瘤的疗效评价标准非靶病灶评价方法,评价客观疗效和不良反应。结果 7例患者心包积液引流量平均为1400 mL,积液均呈暗红色浓血性;采用上述治疗后心包积液均得到控制,有效率为100%,同时心包填塞症状消失,一般情况明显改善。治疗期间无白细胞、血小板及血红蛋白下降等血液不良反应。结论在心包置细管引流的基础上,恩度灌注联合全身化疗治疗恶性心包积液安全有效,能够改善患者的生活质量,延长生存期,值得临床上进一步观察研究。
Objective To observe the efficacy and safety of recombinant human endostatin injection（endostar）for pericardial cavity infusion therapy combined with systematic chemotherapy on the malignant pericardial cavity effusion.Methods 7 patients diagnosed as serious malignant pericardial cavity effusion were included.After pericardial cavity effusion was fully drained with central venous catheter,endostar 30-45mg were administrated into the pericardial cavity.3-5 days later,if there was no effusion confirmed with B ultrasonic examination,catheter can be removed.If there was still some effusion,drainage and the drugs above should be applied again.Each patient treated at most 6 times.At the same time,systematic chemotherapy was applied according to different status of each patient.The efficacy and adverse reactions were evaluated according to the serous effusions efficacy evaluation criteria and the non-target lesion evaluation method of response evaluation criteria in solid tumors by WHO.Results The average draught flow volume of pericardial effusion was 1400ml in 7 patients,which were concentrated dark red.All the 7 patients achieved relief of the pericardial cavity effusion,efficacy 100%.Tamponade symptoms disappeared,the significant improvement in the general were observed.There were no adverse reactions during treatment in blood such as decreased white blood cells,platelets and hemoglobin.Conclusion Endostar pericardial cavity infusion therapy combined with systematic chemotherapy is safe and effective for malignant pericardial cavity effusion,which can improve the quality of life and extent survival,thus is worthy of further clinical observation and study.
出处
《医学综述》
2012年第22期3889-3891,共3页
Medical Recapitulate
关键词
恶性心包积液
治疗
恩度
Malignant pericardial cavity effusion
Treatment
Endostar
