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中文摘要：
目的探讨胸腔镜心包开窗术联合局部灌注化疗治疗恶性心包积液的价值。方法选取浙江省金华市中心医院2013年6月～2014年12月收治的30例恶性心包积液患者作为观察组，采用胸腔镜心包开窗术联合局部灌注化疗治疗；抽取2009年12月～2014年12月收治的采用胸腔镜心包开窗术治疗的30例恶性心包积液患者作为对照组1，采用胸腔镜心包开窗术治疗；选取2009年12月～2014年12月采用内科保守治疗的30例恶性心包积液患者作为对照组2，采用内科保守治疗。观察三组患者短期疗效（疾病缓解率）、长期疗效（疾病进展时间、生存期和Karnofsky功能状态评分）及复发率。结果观察组平均手术时间（45．1±10．7）min，术后无住院死亡病例．缓解率为100．0％，对照组1缓解率为83．3％，对照组2缓解率为73．3％，差异有统计学意义（P〈0．05）。观察组短期疗效优于对照组1和对照组2（P〈0．05）。观察组疾病进展时间为（8．7±1．2）个月，生存期为（14．3±3．2）个月；对照组1疾病进展时间为（10．8±1．8）个月，生存期为（12．2±1．8）个月；对照组2疾病进展时间为（3．0±1．1）个月，生存期为（6．8±1．9）个月，三组疾病进展时间和生存期比较差异有高度统计学意义（P〈0．01）。对照组2疾病进展时间显著短于观察组和对照组l（P〈0．01）；观察组生存期显著长于对照组1和对照组2（P〈0．01）。治疗前，三组患者Karnofsky功能状态评分比较差异无统计学意义（P〉0．05）；治疗后，三组患者Karnofsky功能状态评分较治疗前升高（P〈0．05），观察组Karnofsky功能状态评分明显较对照组1和对照组2高（P〈0．01）。观察组无一例心包积液复发，对照组1复发率为6．7％，对照组2复发率为13．3％，差异有统计学意义（P〈0．05）。结论胸腔镜心包开窗术联合局部灌注化疗治
英文摘要：
Objective To explore the value of thoracoscopic pericardial fenestration combined with local infusion chemotherapy in the treatment of malignant pericardial effusion. Methods 30 cases of malignant pericardial effusion patients admitted Central Hospital of Jinhua City in Zhejiang Province from June 2013 to December 2014 were selected as observation group, thoracoscopic pericardial fenestration combined with local infusion chemotherapy were used in observation group. 30 cases of malignant pericardial effusion patients from December 2009 to December 2014, were selected as control group 1 treated with thoracoscopic pericardial fenestration. 30 cases of malignant pericardial effusion patients from December 2009 to December 2014 were selected as control group 2 treated with conservative treatment. Short-term effect （remission rate）, long-term efficacy （progression time, survival time and Karnofsky score） and recurrence rate among three groups were observed. Results The mean operative time of observation group was （45.1±10.7） min, and no patients deaths after surgery, and remission rate was 100.0%; remission rate of control group 1 and control group 2 was 83.3%, 73.3% respectively, with statistical difference （P 〈 0.05）. Short-term effect of observation group were better than those of control group 1 and control group 2 （P 〈 0.05）. Progression time was （8.7±1.2） months, survival time was （14.3±3.2） months in observation group; progression time was （10.8±1.8） months, survival time was （12.2±1.8） months in control group 1; progression time was （3.0±1.1） months, survival time was （6.8±1.9） months in control group 2; progression time and survival time among three groups were compared, with significantly statistical differences （P 〈 0.01）. Progression time of control group 2 was significantly shorter than those of observation group and control group 1 （P 〈 0.01）. Survival time of observation group was significantly longer than those of control group 1 and con
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