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目的评价进展期胃癌患者术中腹腔内植入缓释氟尿嘧啶植入剂进行腹腔化疗的安全性及疗效。方法对57例进展期胃癌患者进行回顾性研究:其中28例进行术中腹腔内植入缓释氟尿嘧啶植入剂进行腹腔化疗,术后1个月无化疗禁忌后行常规化疗。29例未行任何腹腔化疗,术后1个月化疗禁忌后行常规化疗。用药前:详询病史、全面体检;术前各项常规检查;同时观察恶心呕吐、发热、腹泻、腹痛等体征。术后观察切开愈合、肠梗阻等并发症;复查用药前各项检查指标。记录2年生存率。结果在化学性腹膜炎、切口感染和裂开、吻合口漏、腹腔感染以及粘连性肠梗阻这4个方面相比较两组均无明显差异。治疗组消化道反应的发生率高于对照组(P<0.05),但均为轻度反应,两组病例在骨髓抑制、肝功能异常和肾功能异常这3个方面相比较差异均无统计学意义(P>0.05)。两组病例1年生存率差异无统计学意义(P>0.05),治疗组相对于对照组的2年生存率差异有统计学意义(P<0.05)。结论进展期胃癌患者术中腹腔内植入缓释氟尿嘧啶植入剂是一种安全、有效的腹腔化疗方法。
Objective To evaluate the safety and efficacy of intraperitoneal implantation of sustained-release fluorouracil implants for intraperitoneal chemotherapy in patients with advanced gastric cancer. Methods 57 patients with advanced gastric cancer were retrospectively studied. Among them, 28 patients underwent intraperitoneal implantation of sustained-release fluorouracil intraperitoneal chemotherapy for intraperitoneal chemotherapy. One month after chemotherapy, they were treated with conventional chemotherapy without any contraindication. 29 cases did not undergo any intraperitoneal chemotherapy, chemotherapy was contraindicated 1 month after conventional chemotherapy. Medication: detailed medical history, a comprehensive physical examination; preoperative routine examination; at the same time observe the nausea and vomiting, fever, diarrhea, abdominal pain and other signs. Postoperative observation of incision healing, intestinal obstruction and other complications; review before the test indicators. Record 2-year survival rate. The results in the chemical peritonitis, incision infection and dehiscence, anastomotic leakage, abdominal infection and adhesive intestinal obstruction in these four aspects compared with no significant difference between the two groups. The incidence of digestive tract reaction in the treatment group was higher than that in the control group (P <0.05), but both were mild reactions. There was no significant difference in the three groups between the two groups in terms of myelosuppression, liver dysfunction and renal dysfunction Significance (P> 0.05). There was no significant difference in one-year survival rate between the two groups (P> 0.05). The 2-year survival rate of the treatment group was significantly different from that of the control group (P <0.05). Conclusion Intraperitoneal implantation of sustained-release fluorouracil implants in patients with advanced gastric cancer is a safe and effective method for intraperitoneal chemotherapy.