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目的探讨腹腔内灌注重组人p53腺病毒注射液(rAd-p53)及化疗联合区域热疗治疗恶性腹腔积液的临床疗效及毒副作用。方法 50例恶性腹水患者分为2组,观察组25例尽量引流后腔内注射rAd-p53 1×1012VP,48~72 h后腹腔内再注入顺铂40 mg/m2,帮助患者变换体位,当日行腹部亚高温射频透热热疗1 h,热疗2次/周,疗程共4周。对照组除不给予rAd-p53外,腔内化疗、热疗与观察组相同。结果观察组有效率(CR+PR+SD)为88.0%,对照组为64.0%(P<0.05)。2组均偶有恶心、呕吐、皮下脂肪硬结等Ⅰ~Ⅱ度不良反应,观察组特有的不良反应主要为自限性发热。结论腔内rAd-p53联合化疗及局部热疗控制恶性腹腔积液疗效好、安全。
Objective To investigate the clinical efficacy and side effects of intraperitoneal injection of recombinant human adenovirus p53 (rAd-p53) and chemotherapy combined with regional hyperthermia in the treatment of malignant ascites. Methods Fifty patients with malignant ascites were divided into two groups. In the observation group, 25 cases were treated with rAd-p53 1 × 1012VP after drainage and intraperitoneal injection of cisplatin (40 mg / m2) 48-72 h after drainage to help the patient change position. Line abdominal hypothermia radiofrequency thermotherapy 1 h, hyperthermia 2 times / week, a total of 4 weeks. In addition to the control group was not given rAd-p53, endovascular chemotherapy, hyperthermia and observation group the same. Results The effective rate (CR + PR + SD) of the observation group was 88.0% and that of the control group was 64.0% (P <0.05). Both groups had occasional nausea, vomiting, subcutaneous fat induration, such as grade Ⅰ ~ Ⅱ adverse reactions, the observation group of specific adverse reactions mainly self-limiting fever. Conclusions The combination of rAd-p53 and local hyperthermia in the treatment of malignant ascites is effective and safe.