rmhTNF联合顺铂腔内注射治疗恶性浆膜腔积液的临床观察

陈剑波

【摘要】 目的：评价重组改构人肿瘤坏死因子（rmhTNF）聯合顺铂治疗恶性浆膜腔积液的疗效、安全性和对患者生活质量的影响。方法：选取2011年8月-2015年7月笔者所在医院肿瘤内科收住院的符合本研究标准的中晚期恶性肿瘤合并恶性浆膜腔积液的患者83例，采用信封法随机抽取分为两组，试验组38例，对照组45例。试验组抽取浆膜腔积液后腔内灌注顺铂50 mg/m2及rmhTNF 150万单位，对照组抽取浆膜腔积液后采用顺铂50 mg/m2单药灌注。观察比较两组患者的临床疗效、不良反应及生活质量。结果：试验组治疗有效率为84.2%（32/38），高于对照组的64.4%（29/45），比较差异有统计学意义（P<0.05）；试验组患者治疗后1周KPS评分较治疗前均明显改善，比较差异均有统计学意义（P<0.05）；不良反应发生率与对照组比较，差异无统计学意义（P>0.05）。结论：rmhTNF联合顺铂腔内注射治疗恶性浆膜腔积液可取得更加满意的疗效，有效提高疾病控制率，改善患者生活质量，值得临床推广。

【关键词】 恶性浆膜腔积液； 肿瘤； 重组改构人肿瘤坏死因子； 联合

doi：10.14033/j.cnki.cfmr.2017.32.002 文献标识码 A 文章编号 1674-6805（2017）32-0004-03

Clinical Observation of rmhTNF and Cisplatin in the Treatment of Malignant Serous Effusion/CHEN Jianbo.//Chinese and Foreign Medical Research，2017，15（32）：4-6

【Abstract】 Objective：To evaluate the efficacy and safety of recombinant human tumor necrosis factor （rmhTNF）and its effect on the quality of life of patients.Method：From August 2011 to July 2015，83 patients with advanced malignant neoplasm associated with malignant serous effusion admitted to our hospital for oncology were randomly divided into two groups according to the envelope method，38 in the experimental group and 45 in the control group.Patients in the experimental group were perfused with 50 mg/m2 of Cisplatin and 1.5 million units of rmhTNF；patients in the control group were perfused with 50 mg/m2 of Cisplatin.The therapeutic effect，adverse reactions and quality of life were observed and compared between the two groups.Result：The effective rate of the treatment group was 84.2%（32/38），which was higher than 64.4%（29/45） of the control group，the difference was statistically significant（P<0.05）.The KPS score of the experimental group was significantly improved 1 week after treatment compared with before treatment，the difference was statistically significant（P<0.05）；there was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）.Conclusion：rmhTNF combined with cisplatin in the treatment of malignant serous effusion can achieve more satisfactory curative effect，effectively the disease control rate and improve quality of life of patients，worthy of clinical promotion.

【Key words】 Malignant serous effusion； Cancer； rmhTNF； Combination

First-authors address：The First Affiliated Hospital of Xiamen University，Xiamen 361003，China

恶性浆膜腔积液是恶性肿瘤晚期患者常见的严重并发症之一，临床上常反复出现，难以根治，如能有效控制，对于提高该类患者的生活质量从而延长生存期有着重大意义。目前临床上普遍采用穿刺置管引流等手段以减轻痛苦、缓解症状。选取笔者所在医院2011年8月-2015年7月应用重组改构人肿瘤坏死因子（rmhTNF）联合顺铂治疗恶性浆膜腔积液的患者，评价该治疗方法的疗效、安全性和对患者生活质量的影响情况，现报道道如下。endprint