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目的研究直肠癌术中腹腔多次冲洗,对于降低患者腹腔内脱落癌细胞阳性率的临床意义。方法对63例直肠癌患者术中腹腔冲洗分6次进行,肿瘤切除前3次,切除后3次；将6次腹腔冲洗液行常规病理学涂片细胞学检查结果进行对比。结果肿瘤切除前,全组患者腹腔冲洗液脱落癌细胞均呈阳性表达。肿瘤切除后第1次腹腔冲洗液脱落癌细胞阳性40例,第2次阳性33例,第3次阳性13例。肿瘤切除后第1次冲洗液的脱落癌细胞阳性结果与切除后第2次冲洗液阳性结果比较,P＞0．05,差异无统计学意义；但第3次冲洗液的脱落癌细胞阳性结果与第2次比较,P＜0．01,差异有统计学意义。结论对直肠癌患者进行术中多次腹腔冲洗可降低腹腔内脱落癌细胞的阳性率。
Objective To investigate the clinical significance of reducing the positive rate of cancer cells in the abdominal cavity of patients undergoing multiple intraperitoneal washing of rectal cancer. Methods Sixty-three patients with rectal cancer underwent intraoperative peritoneal washing 6 times, 3 times before tumor resection and 3 times after resection. Six times of intraperitoneal washings were compared with routine pathological smear cytology results. Results Before tumor resection, all the patients in the peritoneal washings had positive expression of exfoliated cancer cells. After the tumor was excised, the first peritoneal lavage fluid was detached from cancer cells in 40 cases, the second was positive in 33 cases, and the third was positive in 13 cases. The positive results of exfoliative cancer cells in the first rinse after tumor resection were compared with positive results in the second rinse after excision, P>0.05, the difference was not statistically significant; however, the positive results of exfoliated cancer cells in the third rinse were found. Compared with the second time, P<0.01, the difference was statistically significant. Conclusion The intraoperative intraperitoneal flushing of rectal cancer patients can reduce the positive rate of cancer cells in the abdominal cavity.