【作者】 毋永娟； 云文秀； 杨燕霞； 赵翠云； 张巧凤；

【Author】 Wu Yong-juan Yun Wen-xiu Yang Yan-xia Zhao Cui-yun Zhang Qiao-feng Department of Oncology,Tumor hospital of Bao tou,Inner Mongolia Bao tou 014030

【机构】 内蒙古包头市肿瘤医院肿瘤内科；

【摘要】 目的观察腹腔内热循环联合顺铂灌注治疗恶性腹水的疗效、不良反应、生存质量。方法 56例病理诊断明确恶性腹水患者随机分为两组,治疗组30例,对照组26例;两组均经超声定位置管。治疗组选用直径20-22mm套管针左右侧下腹部或单侧置管,引流腹水后连通TRL2000热化疗灌注机(哈尔滨宇航科技开发有限公司生产)循环灌注0.9%氯化钠1 000-2000ml,入腹温度43℃,出腹温度38-39℃,双循环30分钟,单循环3次。将灌注1 000ml-1 500ml(温度43℃)灌入腹腔保留。每周1次,3周1疗程;对照组常规腹腔置管引流,腹腔内灌注顺铂60mg/m2+地塞米松10mg+生理盐水500-1000ml,每周1次,3周为1疗程。结果近期疗效3个月内腹水控制率治疗组73.3%(22/30),对照组46.15%(12/26)。远期疗效:治疗组1年生存率60.4%,中位生存期10.4个月;对照组1年生存率38.46%,10/26,中位生存期6.03个月。经统计学X~2检验,近期疗效及远期疗效两组比较均有显著差异(P<0.05)。生活质量改善,KPS评分升高比较,治疗组评分升高60%。(18/30)对照组评分升高46.25%(12/26),X~2检验比较两组有显著差异(P<0.05)。主要不良反应恶心、呕吐,无肝肾功能损害。结论腹腔热循环灌注联合顺铂腹腔内化疗,能够有效地控制恶性腹水,改善全身状况,延长生存期,疗效可靠,操作简便,无严重不良反应,宜于临床推广。更多还原

【Abstract】 Objective To observe the therapeutic effectuality of life and toxicity of abdominal cavity heat cycle combined with cisplatin in the treatment of malignant abdominal dropsy.Methods 56 cases with malignant abdominal dropsy,diagnosed with pathology,were divided into two groups at random(one group(treatment group) received abdominal cavity heat cycle combined with cisplatin.All the position of pricking was located by the hypersound.30 cases of the treatment group were put tube into abdominal cavity in one or two sides to drain the abdominal dropsy. Next let the tube which was 20-22mm in diameter contact with TRL2000 to infuse NS 1000-2000ml circularly,the temperature of in-abdomen was 43 and ex-abdomen was 38-39double circulation 30 minute or single circulation 3 times.Next infused cisplatin 60mg/m2 plus Dexamethasone 10mg plus normal saline 1000ml-1500ml,temperature 43 retain in the abdominal cavity,once a week.The regiment was repeated every three weeks For control group(26 cases), only drain the abdominal dropsy then infused cisplatin 60mg/m2 plus Dexamethasone 10mg plus normal saline 500- 1000ml,once a week the regiment was repeated every three weeks.Results The short time efficacy during 3 months the efficacy rate was 73.3%,22/30,in treatment group in control group was 46.15%,12/26.The prostecdtive efficacy the survival rates of 1-year was 60.4%and median survival time was 10.4 months in treatment group the survival rates of 1-year was 38.46%(10/26) and median survival time was 6.03 months in control group.Evaluated by x~2 between treatment group and control group the difference both efficacy rate in the short time and the prostecdtive efficacy were significant(P<0.05).Meanwhile,KPS score were increased,the ratio of increasing score was 60%18/30 in treated group and 46.25%,12/26 in control group,the difference was significant(P<0.05).The main toxicities were nausea vomit and there were no other severe tissue damage.Conclusion Abdominal cavity heat cycle combined with cisplatin infusion therapy could control the malignant abdominal dropsy,improve the long-term survival rate and significantly enhance the quality of life.It is easily handledeffective safe and application,thus,the treatment should be taken in clinic.更多还原