【摘要】：目的:觀察恩度聯(lián)合胸腔熱灌注化療對非小細胞肺癌患者胸腔積液及循環(huán)內(nèi)皮細胞的影響。方法:以62例非小細胞肺癌患者為研究對象,隨機分為對照組30例和觀察組32例,經(jīng)胸腔穿刺引流后,對照組將20mg順鉑注入胸腔內(nèi),行胸腔循環(huán)熱灌注1小時,循環(huán)結(jié)束后,給予胸腔內(nèi)注入順鉑40mg-60mg。每周2次,連用2周;觀察組:將20mg順鉑注入胸腔內(nèi),行胸腔循環(huán)熱灌注1小時,循環(huán)結(jié)束后,給予胸腔內(nèi)注入順鉑40mg-60mg并注入恩度30mg。每周2次,連用2周;觀察兩組患者胸腔積液的緩解情況及不良反應(yīng)率,檢測兩組患者治療前后外周血CECs及a CECs的含量。結(jié)果:治療后對照組胸腔積液總有效率為53.33%:觀察組總有效率為86.38%,兩組總有效率有統(tǒng)計學(xué)差異(P0.05)。治療后對照組不良反應(yīng)(均為I II級)發(fā)生人次30例,觀察組不良反應(yīng)(均為I II級)發(fā)生人次29例,兩組不良反應(yīng)發(fā)生率無統(tǒng)計學(xué)差異(P≥0.05)。經(jīng)治療后,對照組CECs及a CECs含量相對治療前無統(tǒng)計學(xué)差異(P0.05),觀察組CECs及a CECs含量相對治療前明顯降低,有統(tǒng)計學(xué)差異(P0.05);不同療效間患者CECs及a CECs含量比較,對照組CR+PR患者相對SD+PD患者CECs及a CECs降低,觀察組CR+PR患者相對SD+PD患者CECs及a CECs明顯降低,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:通過采用恩度聯(lián)合胸腔熱灌注化療的治療方法,使非小細胞肺癌患者胸腔積液改善明顯,生活質(zhì)量改善顯著,并未增加不良反應(yīng)率。同時可降低患者外周血CECs和a CECs含量。胸腔積液控制情況與外周血CECs及a CECs含量呈負相關(guān),即胸腔積液療效越顯著,CECs及a CEC含量下降越明顯。
[Abstract]:Aim: to observe the effect of Endo combined with intrapleural hyperthermic chemotherapy on pleural effusion and circulating endothelial cells in patients with non-small cell lung cancer (NSCLC). Methods: 62 patients with non-small cell lung cancer (NSCLC) were randomly divided into control group (n = 30) and observation group (n = 32). After thoracic puncture and drainage, 20mg cisplatin was injected into the thoracic cavity of the control group. Cisplatin was injected into the thoracic cavity of 40 mg / g and 60 mg 路kg-1, respectively. The observation group: 20mg cisplatin was injected into the thoracic cavity for 1 hour, and after the end of the circulation, cisplatin 40mg-60mg was injected into the chest cavity and Endo 30 mg 路kg-1 was injected into the chest cavity. Two times a week for 2 weeks, the remission and adverse reaction rate of pleural effusion in two groups were observed, and the levels of CECs and a-CECs in peripheral blood were measured before and after treatment. Results: after treatment, the total effective rate of pleural effusion was 53.33% in the control group, 86.38% in the observation group, and there was statistical difference between the two groups (P0.05). There were 30 cases in the control group (all of them I / II grade) and 29 cases in the observation group (I / II grade) after treatment. There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). After treatment, the contents of CECs and a-CECs in the control group were not significantly different before treatment (P0.05), but the CECs and a-CECs contents in the observation group were significantly lower than those before treatment (P0.05). The contents of CECs and a-CECs in patients with different therapeutic effects were significantly lower than those in patients with SD PD in the control group (P < 0.05), and the CECs and a-CECs in the patients with CR PR in the observation group were significantly lower than those in the SD PD patients in the observation group (P0.05). Conclusion: the pleural effusion and quality of life of patients with non-small cell lung cancer (NSCLC) were significantly improved by Endo combined with intrapleural hyperthermic chemotherapy, and the adverse reaction rate was not increased. At the same time, the contents of CECs and a CECs in the peripheral blood of the patients were decreased. The control of pleural effusions was negatively correlated with the contents of CECs and a CECs in peripheral blood. That is to say, the more effective the pleural effusions were, the more obvious the contents of CECs and a CEC decreased.
【學(xué)位授予單位】：河北大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R734.2

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