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目的探讨卡培他滨联合顺铂(DDP)腹腔灌注治疗进展期胃癌并腹腔积液患者的疗效,分析临床疗效和不良反应。方法选择64例进展期胃癌伴腹腔积液的患者,随机分为治疗组和对照组,各32例。两组均采用中心静脉导管腹腔穿刺置管进行持续腹水引流后,通过导管腹腔内注入0.9%氯化钠60ml+DDP60～80mg和地塞米松10mg及利多卡因200mg,夹管7d后,重复上述治疗1次,连用2次,停7d,21d为一个疗程。治疗组同时给予卡培他滨1250mg/m2口服,2次/d,连用14d,停7d,21d为一个疗程。两个疗程结束后评价。结果治疗组和对照组总有效率分别为68.75%和43.75%,差异有统计学意义(χ2=4.06,P<0.05);临床受益率分别为71.88%和40.63%,差异有统计学意义(χ2=6.35,P<0.05)。消化道反应、肝肾功能异常和骨髓抑制主要不良反应差异无统计学意义(χ2=0.16～1.11,P>0.05),Ⅰ、Ⅱ度手足综合征发生率治疗组高于对照组(χ2=6.62,P<0.05)。结论卡培他滨联合DDP腹腔灌注治疗进展期胃癌伴腹腔积液患者的疗效满意,不良反应发生率低,耐受性好。
Objective To investigate the curative effect of capecitabine combined with cisplatin (DDP) peritoneal perfusion in patients with advanced gastric cancer and ascitic fluid and to analyze the clinical efficacy and adverse reactions. Methods 64 patients with advanced gastric cancer with ascites were randomly divided into treatment group and control group, with 32 cases in each group. Both groups were treated with central venous catheter for continuous ascites drainage after catheterization, and then intraperitoneal injection of 0.9% sodium chloride 60ml + DDP 60-80mg and dexamethasone 10mg and lidocaine 200mg intraperitoneally after catheterization for 7 days, Treatment 1, once every 2, stop 7d, 21d for a course of treatment. The treatment group also given capecitabine 1250mg / m2 orally, 2 times / d, once every 14d, stop 7d, 21d for a course of treatment. After two courses evaluation. Results The total effective rates of the treatment group and the control group were 68.75% and 43.75%, respectively, with significant difference (χ2 = 4.06, P <0.05). The clinical benefit rates were 71.88% and 40.63% respectively, with significant difference (χ2 = = 6.35, P <0.05). There was no significant difference in the main adverse reactions of digestive tract reaction, liver and kidney dysfunction and myelosuppression (χ2 = 0.16-1.11, P> 0.05). The incidence of hand-foot syndrome in Ⅰ and Ⅱ hands was higher in the treatment group than in the control group (χ2 = 6.62 , P <0.05). Conclusion Capecitabine combined with DDP peritoneal perfusion in patients with advanced gastric cancer with ascites has satisfactory curative effect, low incidence of adverse reactions and good tolerance.