【摘要】 目的比较常规腹腔化疗与腹腔热灌注化疗(HIPEC)的临床疗效差异,探讨HIPEC的临床应用价值与优势。方法将2015年1月~2016年1月唐山市人民医院收治的86例患者依照治疗方式不同分为观察组(44例)及对照组(42例)。两组患者均采用常规腹膜腔穿刺方案将腹水放尽,观察组采用HIPEC疗法进行治疗,后使用四极板内生场热疗进行干预,对照组患者仅进行腹腔灌注治疗。记录HIPEC治疗时观察组患者不同时间点(治疗0、15、60 min时)生命体征及温度变化情况;比较两组患者的临床疗效、Kamofsky评分变化情况、不良反应情况。结果治疗过程中观察组患者生命体征及温度无明显变化(P>0.05)。观察组患者临床疗效显著优于对照组(P<0.01);治疗前,两组患者Kamofsky评分比较差异无统计学意义(P>0.05),治疗后两组患者Kamofsky评分均较治疗前显著升高(P<0.01),且观察组患者评分明显优于对照组,差异有高度统计学意义(P<0.01);两组患者骨髓抑制、恶心呕吐、肠梗阻、脂肪硬结发生率比较差异无统计学意义(P>0.05),但观察组患者腹痛发生率显著高于对照组(P<0.01)。结论 HIPEC可显著提高恶性腹水治疗的临床疗效、改善Kamofsky评分,且具有较高的安全性,可作为治疗恶性腹水的有效方案在临床中推广应用。更多还原

【Abstract】 Objective To compare the clinical therapeutic effect of conventional intraperitoneal chemotherapy with itraperitoneal chemotherapy hyperthermic,and explore the clinical value and advantages of HIPEC.Methods Eighty-six patients admitted in the People’s Hospital of Tangshan City from January 2015 to January 2016 were divided into observation group and control group according to the different treatment,and 44 cases were set as the observation group,42 cases were set as the control group.Patients of the two groups were treated with routine peritoneal cavity puncturing scheme put the ascites,and the observation group was treated with HIPEC therapy.After using four board endogenetic field thermotherapy in intervention,patients in the control group were only treated with intraperitoneal perfusion; observation group were treated with HIPEC.Changes of life signs and temperature at different time points(treated for 0,15,60 min) of patients in the observation group during the HIPEC treatment record.The clinical curative effect,Karnofsky score changes,adverse reactions were compared.Results In the course of treatment life signs and temperature of patients in observation group had no significant changes(P>0.05).The clinical efficacy of the observation group was significantly better than that of the control group(P<0.01).Before treatment,the Karnofsky score between the two groups had no statistically significant difference(P>0.05).After treatment,Karnofsky scores of the two groups were significantly increased compared with before treatment(P<0.01),and the score of the observation group was significantly better than that of the control group,the difference was statistically significant(P<0.01).Incidence of bone marrow suppression,nausea and vomiting,bowel obstruction,and adipose scleroma of the two groups had no statistically significant difference(P>0.05),but the incidence of abdominal pain of the observation group was significantly higher than that of the control group(P<0.01).Conclusion HIPEC can significantly improve the clinical efficacy and Kamofsky score of patients with malignant ascites,and is high security,it is worthy of clinical application for the treatment of malignant ascites.更多还原