胸腔内注射白介素-2与博来霉素注射液治疗恶性胸腔积液对肺功能影响的比较

发布时间：2018-09-09 08:21

【摘要】：目的：经胸腔内注射白介素-2(IL-2)和博来霉素（BLM）注射液局部治疗恶性胸腔积液患者，观察抽尽胸水后，胸腔注药治疗前后肺功能、动脉血气变化，探讨两药对患者肺功能的影响，提供临床安全用药参考。方法：选择确诊的中大量恶性胸水患者60例，采用胸腔管置管引尽胸水，将患者分为两组，IL-2单药组（A组）和BLM单药组（B组），经导管注入胸腔，比较治疗前后肺功能、动脉血气变化。结果：A组经治疗后对比肺活量(VC)、最大通气量(MVV)、1秒钟用力呼气容积(FEV1)较用药前有增加，增加幅度为13.76%、8.63%、10.37%，均值均有统计学意义(P0.05)。FVC降低，下降幅度为4.66%，均值无具统计学意义(P0.05)。1秒钟用力呼气容积占用力肺活量百分比(FEV1／FVC)降低幅度为15.59%，均值有统计学意义(P0.05)。最大呼气流速(PEF)指标增长幅度为0.52%，均值无统计学意义(P0.05)。动脉血氧分压（PaO2）升高幅度为4.89%，均值有统计学意义(P0.05)。B组治疗后VC、FEV1指标分别下降12.80%、11.51%、均值有统计学意义(P0.05)。FVC、MVV及FEV1／FVC指标下降为3.07%、8.70%、0.87%，均值不具统计学意义。最大呼气流速(PEF)指标下降3.58%，均值无统计学意义(P0.05)。PaO2下降2.91%，均值无统计学意义(P0.05)。结论：观察A、B两组病例经胸腔内注药治疗恶性胸腔积液前后肺功能及动脉血气变化表明胸腔内灌注IL-2治疗恶性胸腔积液未加重患者限制性肺功能障碍，对近期肺功能无负面影响，使胸腔积液得到控制，在一定程度上改善了限制性通气功能障碍，，并增加了PaO2。B组病例用药后患者肺通气功能及肺容量指标较用药前有所下降，说明BLM胸腔灌注治疗恶性胸腔积液后对肺功能有一定程度的不利影响。
[Abstract]:Objective: to observe the changes of pulmonary function and arterial blood gas in patients with malignant pleural effusion after intrapleural injection of interleukin-2 (IL-2) and bleomycin (BLM) injection. To provide reference for safe drug use in clinic. Methods: sixty patients with malignant pleural effusion were divided into two groups: group A (single drug group) and group B (group B). Pulmonary function was compared before and after treatment. Changes of arterial blood gas. Results after treatment, the forced expiratory volume (FEV1) in 1 second of (VC), maximal ventilation volume (FEV1) was increased by 13.767.63 and 10.37, and the mean value was significantly lower than that before treatment (P0.05). The decrease was 4.66 and the mean value was not statistically significant (P0.05). The percentage of forced expiratory volume occupied by vital capacity (FEV1/FVC) was reduced to 15.59. The mean value was statistically significant (P0.05). The maximum expiratory flow rate (PEF) increased by 0. 52 and had no statistical significance (P0.05). The increase of arterial partial pressure of oxygen (PaO2) was 4.89, the mean value was statistically significant (P0.05). The VC,FEV1 index of group B decreased 12.80 and 11.51, respectively. The mean value was statistically significant (P0.05). The index of FEV1/FVC and FEV1/FVC were decreased to 3.07 and 8.70. The mean value was not statistically significant. The maximum expiratory flow rate (PEF) decreased by 3.58, the mean value was not statistically significant (P0.05). PaO2 decreased by 2.91, the mean value was not statistically significant (P0.05). Conclusion: the changes of pulmonary function and arterial blood gas before and after treatment of malignant pleural effusion by intrapleural injection of IL-2 in group A and B showed that the restrictive pulmonary dysfunction was not aggravated by intrapleural perfusion of IL-2 in the treatment of malignant pleural effusion. There was no negative effect on pulmonary function in the near future, so that pleural effusion was controlled, restrictive ventilation dysfunction was improved to some extent, and pulmonary ventilation function and lung volume index were decreased in PaO2.B group after treatment. The results showed that BLM infusion had some adverse effects on pulmonary function after the treatment of malignant pleural effusion.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R561.3

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