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目的探讨多西他赛和顺铂联合全身热疗治疗晚期胃癌并发腹腔积液的临床效果。方法选取2013年2月至2015年5月间辽宁省阜新市第二人民医院(阜新市妇产医院)收治的140例晚期胃癌并发腹腔积液患者,采用随机数字表法分为观察组与对照组,每组70例。观察组患者在多西他赛与顺铂热灌注治疗基础上加用全身热疗,对照组患者给予多西他赛与顺铂热灌注治疗,比较两组患者治疗前后生活质量评分(KPS)、腹水控制情况、疾病控制率及不良反应发生情况。结果治疗后,观察组患者KPS评分改善比例为75.7%,明显高于对照组的54.3%,两组比较差异有统计学意义(P<0.05);观察组患者腹水控制情况总有效率为94.3%,明显高于对照组的82.9%,差异有统计学意义(P<0.05);观察组患者疾病控制率为68.6%,对照组患者疾病控制率为48.6%,两组比较差异有统计学意义(P<0.05);两组患者不良反应均以恶心、呕吐、腹泻、血小板减少、脱发及手足综合征为主,观察组患者Ⅲ~Ⅳ级不良反应发生率明显低于对照组患者,差异有统计学意义(P<0.05)。结论多西他赛和顺铂联合全身热疗治疗晚期胃癌并发腹腔积液临床效果显著,明显控制腹水进展,提升疾病控制率,改善患者生活质量,不良反应发生率低,值得临床推广。
Objective To investigate the clinical effect of docetaxel combined with cisplatin combined with systemic hyperthermia in the treatment of advanced gastric cancer complicated with ascites. Methods From February 2013 to May 2015, 140 patients with advanced gastric cancer complicated with ascites admitted to Second People’s Hospital of Fuxin City of Liaoning Province (Fuxin Maternity Hospital) were randomly divided into observation group and control group Group, 70 cases in each group. Patients in the observation group were given systemic hyperthermia on the basis of docetaxel and cisplatin hyperthermia, and those in the control group were given docetaxel and cisplatin by hot perfusion. The quality of life scores (KPS) were compared between the two groups before and after treatment. Ascites control, disease control rates and adverse reactions. Results After treatment, the improvement rate of KPS score in observation group was 75.7%, which was significantly higher than that in control group (54.3%), the difference was statistically significant (P <0.05); the total effective rate of ascites control in observation group was 94.3% , Which was significantly higher than that of the control group (82.9%, P <0.05). The disease control rate was 68.6% in the observation group and 48.6% in the control group, the difference was statistically significant P <0.05). Adverse reactions in both groups were mainly nausea, vomiting, diarrhea, thrombocytopenia, alopecia and hand-foot syndrome. The incidence of grade Ⅲ-Ⅳ adverse reactions in the observation group was significantly lower than that in the control group Significance (P <0.05). Conclusions Docetaxel and cisplatin combined with systemic hyperthermia in the treatment of advanced gastric cancer complicated with ascites have a significant clinical effect, significantly control the progress of ascites, improve the disease control rate and improve the quality of life of patients with low incidence of adverse reactions, which is worthy of clinical promotion.