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目的探讨新辅助化疗(NACT)在胃癌伴幽门梗阻患者中的近期治疗效果。方法将72例接受NACT的胃癌伴幽门梗阻患者分为区域动脉灌注化疗组(A组,38例)和全身静脉化疗组(B组,34例),比较两组患者NACT后的近期疗效。结果两组无因化疗不良反应而停止化疗的病例,亦未出现化疗相关死亡者。A、B组肿瘤根治性切除率和术后并发症发生率比较无统计学差异(94.7%vs.94.1%和5.3%vs.5.9%)(P>0.05);但与B组相比,A组梗阻缓解时间和恢复流质时间缩短(3dvs.6d和6dvs.9d)(P<0.01),术后病理缓解率提高(52.6%vs.23.5%)(P<0.05)。结论胃癌伴幽门梗阻患者采用营养支持联合NACT的耐受性好。与全身静脉化疗相比,区域动脉灌注化疗能改善胃癌伴幽门梗阻患者的梗阻症状,提高术后病理缓解率。
Objective To investigate the recent treatment of neoadjuvant chemotherapy (NACT) in patients with gastric cancer and pyloric obstruction. Methods 72 patients with gastric cancer and pyloric obstruction receiving NACT were divided into regional arterial infusion chemotherapy (group A, n = 38) and systemic vein chemotherapy (group B, n = 34). The short-term curative effect was compared between the two groups. Results There were no chemotherapy-related deaths in both groups due to the adverse reaction of chemotherapy. There was no significant difference in the rates of radical resection and postoperative complications between groups A and B (94.7% vs.94.1% and 5.3% vs.5.9%, P> 0.05). However, compared with group B, A The time of remission and the time of recovery of fluid were shortened (3dvs.6d and 6dvs.9d) (P <0.01), and postoperative pathological remission rate increased (52.6% vs.23.5%) (P <0.05). Conclusion Gastric cancer with pyloric obstruction in patients with nutritional support combined with NACT good tolerance. Compared with systemic intravenous chemotherapy, regional arterial infusion chemotherapy can improve obstruction symptoms of gastric cancer patients with pyloric obstruction and improve postoperative pathological response rate.