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目的观察5-氟尿嘧啶缓释剂间质化疗在结直肠癌根治术中应用的效果和安全性。方法将2011年10月至2013年12月期间入我科行结直肠癌根治术的160例患者作为研究对象。用不完全随机方法将160例行结直肠癌根治术患者随机分成观察组(78例)和对照组(82例)。2组患者均行结直肠癌根治术,术后冲洗腹腔和盆腔;观察组术中植入5-氟尿嘧啶缓释剂进行间质化疗,植入部位为肿瘤切除区域及肠系膜动脉周围;术后2组患者均行常规化疗。观察2组患者术后并发症情况、术后局部复发率、肝转移率及术后24个月时的生存率。结果观察组和对照组患者在腹腔相关并发症及药物毒副作用发生率方面比较差异均无统计学意义(P>0.05)。观察组患者术后12个月和24个月复发率分别为1.3%(1/78)和5.2%(4/78),分别明显低于对照组的8.5%(7/82)和23.2%(19/82),差异均有统计学意义(x~2=8.934,P=0.023;x2=14.834,P=0.004)。观察组肝转移率为10.3%(8/78),明显低于对照组的18.3%(15/82),差异有统计学意义(x~2=12.034,P=0.016);观察组术后24个月时的生存率为94.9%(74/78),明显高于对照组的84.1%(69/82),差异有统计学意义(x~2=11.465,P=0.010)。结论 5-氟尿嘧啶缓释剂间质化疗安全性高,可有效降低结直肠癌根治术后的复发率和肝转移率,延长患者生存时间。
Objective To observe the effect and safety of 5-fluorouracil sustained-release agent interstitial chemotherapy in the treatment of colorectal cancer. Methods 160 patients who underwent radical resection of colorectal cancer in our university from October 2011 to December 2013 were enrolled in this study. 160 patients undergoing radical resection of colorectal cancer were randomly divided into observation group (78 cases) and control group (82 cases) with incomplete random method. The patients in both groups underwent radical resection of colorectal cancer and the peritoneal cavity and pelvic cavity were irrigated after operation. The observation group received 5-fluorouracil sustained-release agent for interstitial chemotherapy, the site of resection was the tumor resection area and the mesenteric artery. The postoperative 2 Group patients underwent routine chemotherapy. Postoperative complications, postoperative local recurrence, hepatic metastasis and survival at 24 months postoperatively were observed. Results There was no significant difference between the observation group and the control group in the incidence of abdominal complications and drug toxicity (P> 0.05). The recurrence rates at 12 months and 24 months in the observation group were 1.3% (1/78) and 5.2% (4/78), respectively, which were significantly lower than those in the control group (8.5%, 7/82) and 23.2% 19/82), the differences were statistically significant (x ~ 2 = 8.934, P = 0.023; x2 = 14.834, P = 0.004). The liver metastasis rate in the observation group was 10.3% (8/78), which was significantly lower than that in the control group (18.3%, 15/82) (x ~ 2 = 12.034, P = 0.016) The survival rate at month was 94.9% (74/78), significantly higher than that of the control group (84.1%, 69/82). The difference was statistically significant (x 2 = 11.465, P = 0.010). Conclusion The high safety of 5-fluorouracil sustained-release drug in interstitial chemotherapy can effectively reduce the recurrence rate and liver metastasis rate after radical operation of colorectal cancer and prolong the survival time of patients.