循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水疗效研究.doc

循环热灌注大剂量顺铂治疗胃肠道肿瘤腹水疗效研究[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 0.05）。 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 0.05). 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[