循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水的疗效分析
开篇：润墨网以专业的文秘视角，为您筛选了一篇循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水的疗效分析范文，如需获取更多写作素材，在线客服老师一对一协助。欢迎您的阅读与分享！
[摘要] 目的 比较循环热灌注大剂量顺铂与单纯灌注化疗治疗胃肠道肿瘤腹水的近期疗效及并发症。 方法 同期胃肠道肿瘤腹水患者103例，随机分为两组，观察组通过腹腔内穿刺置双管建立循环双通路，先缓慢放出腹腔积液，再行循环热灌注，并于灌注液中加入大剂量顺铂，治疗结束后腹腔内存留1 000～1 500 mL灌注液；对照组置腹腔引流管，先予腹腔放液，后灌注1 000 mL加有大剂量顺铂的液体，24 h后放出液体。两个疗程后对其疗效及副反应进行比较。 结果 两组103例患者两个疗程后全部可评价疗效，观察组有效率为90.7%，明显高于对照组的51.0%，两组间差异有高度统计学意义（P < 0.01），毒副反应均较轻微，两组间差异无统计学意义（P > 0.05）。 结论 循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水安全、微创，不良反应少而轻，近期疗效明显。
[关键词] 循环热灌注；大剂量顺铂；胃肠道肿瘤；腹水
[中图分类号] R735 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0056-02
Curative effect analysis of circulates the hot irrigation large dose along the platinum treatment gastro-intestinal tract tumor ascites
CAO Ruyao1 LU Dapeng2 LI Wandai1
1.Department of Tumor, the People's Hospital of Suning County, Hebei Province, Suning 062350, China; 2.Cancer Center, Beijing Shijitan Hospital, Beijing 100038, China
[Abstract] Objective To compare the efficacy and complications of high-dose cisplatin loop perfusion with simple infusion chemotherapy for the treatment of gastrointestinal tumor ascites. Methods 103 cases of gastrointestinal tumor patients with ascites were divided into two group. Observed group was given high-dose hot cisplatin and the temperature was 43℃. Control group was given high-dose cisplatin without hot temperature, after 24 hours to release liquid. Results Two groups of 103 patients after two courses of all efficacy evaluation, efficient of observation group was 90.7%, significantly higher than the control group (51.0%). There was a statistically significant difference between two groups (P < 0.01). The side effects were minor and there was no statistically significant difference between two groups (P > 0.05). Conclusion Circulating the hot irrigation with large dose along the platinum treatment gastro-intestinal tract tumor ascites is security. Side effects are few and light and the short-term effect is obvious.
[Key words] Hyperthermic peritoneal perfusion; High dose Cisplatin; Gastrointestinal cancer; Ascites
体腔积液是晚期肿瘤患者常见的并发症，其中恶性腹水约占60%，以胃癌、大肠癌、肝癌和卵巢癌腹腔转移引起为多见。恶性腹水患者预后差，平均生存期20周[1]，以胃肠道来源的腹水预后最差，生存期仅12～20周[2]。目前，对顽固性恶性腹水，全身化疗效果甚微，通常采用腹腔穿刺排液、腹腔内注入化疗药物或生物制剂以及腹腔静脉分流术等方法，疗效均不尽人意[3]，如何消除腹腔游离癌细胞和残存微小病灶，减少腹水生成，改善患者生存质量是临床上需要解决的问题。腹腔循环热灌注是近年来治疗恶性体腔积液的有效治疗手段，我院采用腹腔循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水，取得较满意的疗效，现报道如下：
1 资料与方法
1.1 一般资料
选择我院2008年2月～2012年1月胃肠道肿瘤腹水住院患者103例，所有病例均经病理学确诊，均为术后腹腔转移或晚期不能手术、且经其他方法治疗不能控制腹水增长者，TNM分期均为Ⅳ期；年龄31～75岁；KPS评分≥60分；所有患者均经B超证实有中等以上腹腔积液，近4周内未用过全身化疗药物，腹腔内未注射任何药物；血常规、肝、肾功能均在正常范围；预计生存期大于12周。无严重心肺功能不全、肝硬化失代偿期、肾功能不全及腹腔广泛粘连等。根据随机法将患者分为循环热灌注组（观察组）54例和腹腔单纯抽液加化疗组（对照组）49例。观察组男32例，女22例;年龄31～75岁，平均51岁；大量腹水21例，中等量腹水33例。对照组男31例，女18例;年龄38～72岁，平均53岁；大剂量腹水17例，中等剂量腹水32例。两组一般资料比较差异无统计学意义（P > 0.05），具有可比性。