【作者】 李森； 张锡； 祖洪亮； 薛英威；

【机构】 胃肠外科哈尔滨医科大学附属第三医院；

【摘要】 目的研究胃癌患者不同腹腔冲洗量对腹腔内脱落癌细胞检出率的影响。方法将170例胃癌患者（M₀130 M₀10例）分为A、B、C三组,A组56（M₀42 M₁16）例患者,B组57（M₀45 M₁12）例患者,C组57（M₀45 M₁12）例患者。患者在开腹后,用200ml、500ml、1000ml生理盐水分别在横结肠上的胃周围及横结肠下的腹腔和盆腔进行腹腔冲洗,然后,从结肠上及盆腔收集冲洗液进行常规病理学涂片及细胞学检查。结果 A组患者腹腔内脱落癌细胞阳性检出率7%（M₀5%M₁19%）,B组腹腔内脱落癌细胞阳性检出率14%（M₀11%M₁25.0%）,C组腹腔内脱落癌细胞阳性检出率23%（M₀20%M₁33.3%）。对于M0的患者,200ml冲洗量的脱落细胞阳性率与500ml冲洗量的脱落细胞阳性率比较和500ml冲洗量的脱落细胞阳性率与1000ml冲洗量的脱落细胞阳性率比较,阳性率有增加,但差异无统计学意义,而200ml冲洗量的脱落细胞阳性率与1000ml冲洗量的脱落细胞阳性率比较,差异有统计学意义。对于M1的患者,200ml冲洗量的脱落细胞阳性率与500ml冲洗量的脱落细胞阳性率比较,500ml冲洗量的脱落细胞阳性率与1000ml冲洗量的脱落细胞阳性率比较和200ml的冲洗量的脱落细胞阳性率与1000ml冲洗量的脱落细胞阳性率比较,阳性率增加,但差异均无统计学意义。结论对于肉眼见M0患者,1000ml腹腔冲洗液的量是最佳的腹腔冲洗量,而对于肉眼见并经并经病理证实的M1患者,增加腹腔冲洗量不能提高脱落细胞检出率。更多还原

【Abstract】 Objective To appraise relevance Between the amount of perfusion saline and positive peritoneal washing cytology（PWC） in gastric cancer.Method 170 cases of gastric cancer patients（M₀ 130 M₁40 cases） are divided into ABC three groups.the number of patients of the three group is 56（M₀A40 M₁A16 cases） in A group,57（M₀B45 M₁B12 cases） in B group and 57（M₀C45 M₁C12 cases） in C group,respectively.After laparotomy 200 ml of normal saline in the group of A,500 ml of normal saline in the group of B and 1000 ml of normal saline in the group of C was instilled and aspirated in each of the following areas of the peritoneal cavity sequentially abdominal under the diaphragm above the transverse colon,abdominal under transverse colon and pelvis specimens are processed in routine methods of pathology and are observed under the microscope.The results were then compared.Results 7%（MoA5%M,A19%） patients had positive PWC in group A,14%（MoBll%M₁B25.0%）had positive PWC in the group B and 23%（M₀C20%M₁C33.3%） had positive PWC in the group C.In term of M0 the comparison of the positive result between M₀A and M₀B and the comparison of the positive result between M₀A and MoB,there is no no significant statistical significance,but comparing the positive result of M₀A with the positive result of M₀C we found that the difference was statistically significant.In term of Ml the comparison of the positive result between M₀A and M₀B,the comparison of the positive result between M₀B and M₀C and the comparison of the positive result between M₀A and MoC.We can not found that the difference was statistically significant.Conclusions 1000ml normal saline volume is the best amount of peritoneal lavage for term of M0,but in term of M1,increasing the mount of normal saline volume of peritoneal lavage can not improving the rate of peritoneal washing cytology.更多还原