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目的评价胃肠道肿瘤术中应用氟尿嘧啶缓释剂腹腔化疗后的效果及安全性。方法收集自2008年11月至2009年4月行胃肠道肿瘤根治手术的56例病例,随机分为腹腔化疗组27例(术中于病灶切除及淋巴结清扫区域留置5-氟尿嘧啶缓释剂进行局部化疗)和单纯手术组29例,以高压液相色谱(HPLC)法检测腹腔化疗组术后腹腔氟尿嘧啶浓度及其变化;分别比较两组术前术后肝肾功能损害、骨髓抑制、术后并发症发生及术后住院天数情况。结果(1)胃肠道肿瘤术中腹腔内留置缓释5-Fu后,随着时间推移,浓度逐渐下降并于全腹腔维持高于5-Fu有效抑瘤浓度以上至少10d。(2)治疗组与对照组病人术前术后白细胞计数、肾功能、肝功能(除术后7d两组ALT数值差异有统计学意义(P<0.05))、术后住院期间两组所发生并发症、住院天数差异无统计学意义(P>0.05)。结论氟尿嘧啶缓释剂术中腹腔化疗后.术后早期可维持较高的腹腔药物浓度;不增加对病人的骨髓抑制及肝肾功能损害,不增加术后并发症的发生率,不延迟术后恢复时间,是一种安全可行的术中辅助化疗方法。
Objective To evaluate the efficacy and safety of intraoperative fluorouracil sustained-release agents after intraperitoneal chemotherapy for gastrointestinal cancer. Methods From November 2008 to April 2009, 56 patients undergoing radical surgery for gastrointestinal cancer were randomly divided into intraperitoneal chemotherapy group (n = 27) (intraoperative resection and clearance of lymph node dissection with 5-fluorouracil sustained-release agent Local chemotherapy and 29 cases of simple operation group. The peritoneal fluorouracil concentrations and their changes after operation in peritoneal chemotherapy group were detected by high pressure liquid chromatography (HPLC). The liver and renal dysfunction and bone marrow suppression were compared between the two groups before and after operation Complications and postoperative hospitalization days. Results (1) After 5-Fu intraperitoneal instillation of 5-Fu intraperitoneally, the concentration gradually decreased and remained above the 5-Fu effective antitumor concentration for at least 10 days in the whole abdominal cavity. (2) The preoperative and postoperative leukocyte count, renal function and liver function in the treatment group and the control group were significantly higher than those in the control group (except for the difference of ALT between the two groups at 7 days after operation (P <0.05) There was no significant difference in complication and hospitalization days (P> 0.05). Conclusions After intraperitoneal chemotherapy with fluorouracil sustained-release agents, the intraperitoneal drug concentration can be maintained early in the operation, the myelosuppression, liver and kidney function can not be increased, the incidence of postoperative complications can not be increased, Recovery time, is a safe and feasible intraoperative adjuvant chemotherapy.