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目的 系统比较结直肠癌病人围手术期腹腔温热化疗 (IPC)与全身化疗 (IVC)的优劣。方法 比较两组术前化疗后腹腔游离癌细胞的阴转率 ;术后 2周、6周时T细胞亚群及NK细胞的变化 ,骨髓抑制和消化道反应、体力状况等临床症状。结果 ①术前腹腔游离癌细胞阳性者IPC组 3例 ,IVC组 2例 ,经术前IPC后开腹即时IPC组均阴性 ,而IVC组 2例仍为阳性 ;②术后 2周时外周血WBC、CD3 、CD4、CD4/CD8和NK细胞下降IVC组更明显 ,两组差异有显著意义 (P <0 0 5 ) ;③两组消化道反应和体力状况下降IPC组优于IVC组。结论 IPC能直接杀灭腹腔游离癌细胞 ,作用于腹腔及内脏微小转移灶 ,对防治大肠癌术后局部复发、腹腔及肝脏转移 ,提高手术疗效具有科学理论依据及确切的临床疗效。
Objective To compare the advantages and disadvantages of perioperative intraperitoneal thermochemotherapy (IPC) and systemic chemotherapy (IVC) in patients with colorectal cancer. Methods The negative conversion rate of peritoneal free cancer cells in the two groups were compared between the two groups. The changes of T cell subsets and NK cells, myelosuppression, digestive tract reaction and physical condition at 2 and 6 weeks after operation were compared. Results ①Preoperative preoperative peritoneal free cancer cells were positive in IPC group 3 cases, IVC group 2 cases, preoperative IPC after open IPC group were negative IPC, and 2 cases of IVC group was still positive; ② 2 weeks after the operation of peripheral blood WBC, CD3, CD4, CD4 / CD8 and NK cells decreased more significantly in IVC group, the difference between the two groups was significant (P <0 05); ③ two groups of gastrointestinal reactions and decreased physical status IPC group was better than IVC group. Conclusion IPC can directly kill peritoneal free cancer cells and act on the tiny metastases of abdominal and visceral organs. It has scientific basis and exact clinical efficacy for prevention and treatment of postoperative local recurrence, peritoneal and hepatic metastasis of colorectal cancer and improving surgical curative effect.