RESUMO
Objective To evaluate the effect and safety of catheter constant drainage combined with pericardial perfusion lentinan in treatment of patients with malignant pericardial effusion caused by lung cancer.Methods One hundred and eighteen patients with malignant pericardial effusion caused by lung cancer were divided into 2 groups by table of random digit,the treatment group (56 cases) was treated by pericardial perfusion lentinan after catheter constant drainage by central venous catheter,and the control group (62 cases) was treated by pericardial perfusion cisplatin after catheter constant drainage by central venous catheter.The therapeutic effect and adverse reaction were contrasted between the two groups.Results There was no significant difference in effective rate between treatment group and control group [89.3％(50/56) vs.83.9％ (52/62),x2 =0.736,P =0.391].The adverse reaction rate of treatment group was significantly lower than that of control group [8.9％ (5/56) vs.24.2％ (15/62),x2 =4.871,P =0.027].There was no significant difference in recurrence rate between treatment group and control group [14.3％(8/56) vs.11.3％(7/62),x2 =0.004,P =0.948].Conclusions Catheter constant drainage combined with pericardial perfusion lentinan for malignant pericardial effusion caused by lung cancer is safety and effective,and can be widely applied to clinical application.
RESUMO
Objective To investigate the feasibility of ultrasound-guided interscalenus brachial plexus block used for the emergency surgery.Method From August to December 2007 80 patients from the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou,ASA Ⅰ to Ⅲ,age 18 to 68 years old,weight 45 to 75 kg,without deformity on the shoulder or neck,without limb paresthesia,without contraindications of interscalenus brachial plexus block,were scheduled for emergency surgery of upper limb.They were randomly divided into two groups:interscalenus block guided by ultrasound group(group U,re =40)and nerve stimulator group(group N,re = 40).Patients of both groups received 20 mL mixture of 0.75%ropivacaine and 2%lidocaine.The onset time,and the analgesic efficacy of axillary nerve,lateral antebrachial cutaneous nerve,radial nerve,median nerve,median cutaneous nerve of arm,median antebrachial cutaneous nerve and ulnar nerve,and duration of anesthesia were observed.Statistical analysis was performed by t test,rank sum test and X2 test.Results The onset time of analgesia after nerve block was shorter in group U than that in group N(P＜0.01).The rate of perfect analgesia after nerve block in group U was higher than that in group N(100%vs.87.5%,X2 = 5.267,P = 0.027).The duration of anesthesia lasted in group U was(378 ± 151)minutes and that in group N was(365 ± 163)minutes(t= 0.363,P = 0.718).ConclusionsCompared with the method of nerve block guided by nerve stimulator,the ultrasound-guided interscalenus block offers faster onset and better analgesic efficacy.It is an ideal technique of brachial plexus block for the emergency surgery.