Treatment of Malignant Effusion with Intracavitary OK-432 Chemical Pleurodesis

악성흡수에 OK-432를 이용한 흉막유착술

  • 김맹호 (고려대학교 부속 고대의료원 흉부외과) ;
  • 이헌재 (고려대학교 부속 고대의료원 흉부외과)
  • Published : 1996.04.01

Abstract

To determine the efficacy of OK-432 as pleural sclerosant, we examined the outcomes in 81 patients (age : 27 to 82 years) with malignant pleural effusion and the outcomes in 64 patients ecieving OK-432 3-10KE(1 Klinische Einheit unit) through a chest tube for malignant pleural effusions. Of 81 patients with malignant pleural effusion, 40 patients had lung cancer. Lung cancer is the most frequent cause of malignant pleural effusion in men and women, in which 57 oyo of it was adenocarcinoma. Eighty seven percent of patient had respiratory symptom. Of the 64 patients with intracavitary injection of OK-432 for malignant pleural effusion, 59 patients had a complete short-term response (no fluid reaccumulation during 1 month after intracavitary injection of OK-432). Five patiens of the non-responders had partial control of effusion, with improvement in respiratory symptoms and these patients underwent thoracentesis. Of the 51 patients who survived longer than 1 month, 48 patients did not have re- accumulation of the fluid during follow up. Fever after intracavitary injection of OK-432 was a majors side effect although but that was easily controlled with non-steroidal anti inflammatory drug therapy, Thus the efficacy of intracavitary OK-4)2 injection for malignant pleural effusion was very helpful.

본 고려대학교 흉부외과 교실에서는 1990년부터 1994년까지 악성흡수로 진단된 81명을 대상으로 악 성흥수의 임상적 인 증상과 원인을 살펴보고, 이 중 64명을 대상으로 화학적 흥막유착술을 실시하여 그 결과를 관찰하였다. 악성흥수의 가장 많은 원인 질환은 남녀 (27세 ∼82세)모두 폐암으로 50 % 의 빈도를 보였고, 가장 흔 한 증상으로는 호흡기 증상이 였다. 화학적 흥막유착술을 실시한 환자의 평균시술횟수는 4회이 였으며, 1달 이내 흥수가 재발하지 않은 단 기간반웅성공율은 92 % 였고, 1달 이상 흥수의 재발이 없었던 장기간 반응성공율은 94 %로 다른 scler- osant보다 높은 성공률을 볼 수 있었다 또한, 화학적흥막유착술을 실시한 후 발생한 부작용은 주로 발 열과 통증으로 이는 비스테로이드성 소염진통제를 투여하여 조절할 수 있었다 악성흥수의 치료에 OK-4)2로 화학적 흥막유착술을 실시하여 좋은 결과를 얻었기에 이에 보고하는 바이다.

Keywords

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