论文部分内容阅读
目的探讨进展期胃癌术中腹腔热灌注化疗对防治腹膜转移的疗效及安全性。方法对40例进展期胃癌患者进行回顾性分析,热化疗组(实验组)20例行根治性手术联合术中腹腔热灌注化疗(H IPEC),采用奥沙利铂350 mg溶于右旋糖酐4000 m l中,加热至41.5℃~42.5℃腹腔内循环灌注40~60 m in;选择同期单纯根治性手术治疗的20例胃癌患者作为对照组,对比分析两组患者的临床指标及预后。结果热化疗组仅少数病例治疗后出现短期血压降低、心率增快及肝肾功能、凝血功能指标异常,两组并发症发生率无明显差异;术后腹腔种植转移率热化疗组为5.0%(1/20),对照组15.0%(3/20);1,2年生存率热化疗组分别为90.0%(18/20)和75.0%(15/20),对照组分别为80.0%(16/20)和60.0%(12/20)。结论 H IPEC可有效防治腹膜转移、提高生存率,且并发症少,可作为进展期胃癌术中的辅助治疗。
Objective To investigate the efficacy and safety of intraperitoneal hyperthermic intraperitoneal chemotherapy in preventing and treating peritoneal metastasis of advanced gastric cancer. Methods Forty patients with advanced gastric cancer were retrospectively analyzed. Twenty patients undergoing thermochemotherapy (experimental group) received radical surgery combined with intraperitoneal hyperthermic intraperitoneal hyperthermic perfusion chemotherapy (H IPEC). The patients were treated with oxaliplatin 350 mg dissolved in dextran 4000 ml , Heated to 41.5 ℃ ~ 42.5 ℃ intraperitoneal perfusion 40 ~ 60 min; select the same period radical surgery of 20 cases of gastric cancer patients as a control group, comparative analysis of the two groups of patients with clinical indicators and prognosis. Results Only a few patients in the thermochemotherapy group experienced short-term hypotension, fast heart rate, abnormal liver and kidney function and coagulation function after treatment. There was no significant difference in the incidence of complications between the two groups. The rate of peritoneal metastasis after operation in the thermochemotherapy group was 5.0% 1/20), and 15.0% (3/20) in the control group. The 1-year and 2-year survival rates were 90.0% (18/20) and 75.0% (15/20) in the thermochemotherapy group and 80.0% (16.0%) in the control group / 20) and 60.0% (12/20). Conclusion H IPEC can effectively prevent and treat peritoneal metastasis, improve survival rate, and less complications, which can be used as adjuvant therapy for advanced gastric cancer surgery.