5-FU门静脉插管化疗预防大肠癌肝转移的临床观察.DOCVIP

临床医学论文-5-FU门静脉插管化疗预防大肠癌肝转移的临床观察 ????????????????????????? 作者：邢曰传 周立忠 孙清阳 王洪波 曹春远 【关键词】? 静脉 　　【摘要】 目的? 探讨大肠癌行5-氟尿嘧啶（5-FU）门静脉插管化疗的临床意义。 方法? 采用严格随机对照前瞻性研究设计，对40例Dukes A、B、C期行大肠癌根治术的患者行门静脉插管5-FU化疗，并以同期40例Dukes A、B、C期行大肠癌根治术非门静脉插管化疗的患者作对照。分别于术后1年、3年、5年进行随访，观察两组患者术后生存时间、肝转移、肿瘤复发等情况。 结果? 插管组术后5年随访平均存活62.3个月，非插管组术后5年随访平均存活50.2个月，前者明显长于后者，差异有显著性（P0.05）;前者肝转移7例，后者肝转移16例，两组差异有显著性（P0.05）;两组死亡的主要原因均为肝转移;两组患者年龄、性别、肿瘤大小、肿瘤分期等因素组间对比差异无显著性（P0.05）。 结论? 影响大肠癌术后生存率的主要原因是癌细胞的肝转移，5-FU门静脉插管化疗对肝转移的预防是行之有效的方法。 　　关键词? 大肠癌 门静脉插管 化疗 肝转移 　　The clinical observation on large intestinal cancer treated with5-FU portal intubation chemotherapy to prevent ansference of liver 　　【Abstract】 Objective To investigate the clinical significance of large intestinal cancer5-FU treated with portal intubation chemotherapy.Methods Retrospective randomly contrasting methods was used.40patients of Dukes A，B，C performed radical large intestinal cancer dissection were made portal intubation and5-FU chemotherapy，meanwhile，choosed40patients of Dukes A，B，C without portal intubation as contrasts in the same time.To observe survival time，transference of liver，tumor reccurrence of two groups after operation，from1to5years of follow-up.Results In treatment group the average survival time after5years of follow-up was62.3months.In contrast group the average survival time was50.2months.The former was obviously longer than the latter，its obviously different（P0.05）.Transference of liver of the former was7cases，the latter was16cases（P0.05）.The cause of death in two groups was also transference of liver.The age，the sex，the size of tumor，the stage were less significant（P0.05）between two groups.Conclusion The main cause of the effects upon the survival rate is hepatic transference of cancer cells，5-FU portal intubation chemotherapy are effective methods to prevent transference of liver. 　　Key words large intestinal cancer portal intubation chemotherapy transference of liver 　　影响大肠癌术后生存率的最主要原因是癌细胞的远处转移，尤其是肝转移。近40年来，虽然大肠癌的手术日臻完善，但术后的辅