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超声引导下留置静脉导管并腔内化疗治疗癌性心包积液的效果 被引量:1

Ultrasound-guided indwelling venous catheter and intracavitary malignant pericardial effusion chemotherapy in the treatment of
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摘要 目的:评价超声引导下留置静脉导管并心包腔内化疗治疗癌性心包积液的近期临床疗效、并发症及其毒性反应。方法:25例恶性心包积液患者在超声引导下心包腔穿刺置入中心静脉导管引流,引净心包积液后,经导管向心包腔内注入顺铂40mg-60mg,足叶乙甙100mg,氟美松(DMX)10mg,嘱患者变换体位,以使药物均匀的弥散到整个心包腔,局部化疗同时全身水化和止吐处理。每周注射药物1次,当24h内心包引流量<50ml可考虑拔管。1-3个疗程后评价疗效。结果:可评价疗效病例25例,CR19例,PR4例,NC2例,RR92%。自开始治疗心包积液计,全组中位生存4.6个月,1年生存率23.6%,最长1例生存时间27个月。毒性反应主要为消化道反应,骨髓抑制,经对症处理均缓解。留置导管时间内无继发感染、凝管及导管脱落,无心前区疼痛、心力衰竭、肺水肿出现;随访中未出现缩窄性心包炎病例。结论:超声引导下心包腔内置管治疗恶性心包积液,疗效较好,安全可靠,不仅可明显提高生存质量,并可延长生存期。 Objective: To evaluate the effect of ultrasound - guided indwelling venous catheter and pericardial cavity chemotherapy in the treatment of malignant pericardial effusion. Methods. Twenty five cases with malignant pericardial effusion in the pericardial cavity ultrasound - guided puncture inserted central venous catheter drainage, primers chance packet effusion, pericardial cavity via catheter to inject cisplatin 40mg -60mg, etoposide100 mg, dexamethasone (DMX) 10mg. Injecting drug once a week, when 24 hours of their hearts packet drainage 〈 50 ml may consider extubation. Results: In 25 cases, CR 19,PR 4, NC 2, RR 92%. Median survival 4.6 months, 1 -year survival rate 23.6%, the longest survival time 27 months. Main side reactions were gastrointestinal toxicity reaction, bone marrow suppression. Conclusion: Ultrasound - guided tube pericardial cavity in the treatment of malignant pericardial effusion, has better efficacy, safety and reliability.
机构地区 青海红十字医院
出处 《现代肿瘤医学》 CAS 2008年第7期1174-1175,共2页 Journal of Modern Oncology
关键词 超声引导下 中心静脉导管 腔内化疗 癌性心包积液 ultrasound - guided central venous catheter intracavitary chemotherapy malignant pericardial effusion
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