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目的探讨胃肠癌采用盆腔和腹腔热灌注化疗治疗的临床效果。方法选取66例胃肠癌患者作为研究对象,随机进行分组;对照组(n=33例)单纯采取开腹或腹腔镜D2胃癌根治性切除术,观察组(n=33例)在对照组治疗的基础上,术中给予盆腔和腹腔热灌注化疗治疗;对比两组患者的临床效果观察指标,综合评价患者的疗效。结果治疗前后,观察组患者的腹腔冲洗液游离癌细胞阳性率改善程度显著大于对照组(P<0.05);两组患者的毒副反应、生命体征恶化、腹腔感染、吻合口漏及围术期死亡的发生情况,差异均未见统计学意义(P>0.05);观察组患者2年复发率、3年复发率、癌细胞转移率均显著低于对照组,2年生存率及3年生存率均显著低于对照组;两组差异有统计学意义(P<0.05)。结论胃肠癌采用盆腔和腹腔热灌注化疗治疗的临床效果确切,可显著延长患者的总生存期、减少癌细胞转移及总复发率,治疗安全性高,未增加不良反应,具有临床可行性。
Objective To investigate the clinical effect of pelvic and intraperitoneal hyperthermic chemotherapy in patients with gastrointestinal cancer. Methods Sixty-six patients with gastrointestinal cancer were selected and divided into groups randomly. The control group (n = 33) was treated by open radical resection alone or laparoscopic D2 gastric cancer radical resection. The observation group (n = 33) On the basis of intraoperative pelvic and intraperitoneal hot perfusion chemotherapy treatment; comparison of two groups of patients clinical observation indicators, comprehensive evaluation of the efficacy of the patients. Results Before and after treatment, the positive rate of free cancer cells in the peritoneal washings in the observation group was significantly higher than that in the control group (P <0.05). The adverse reaction, the deterioration of vital signs, abdominal infection, anastomotic leakage and perioperative period (P> 0.05). The 2-year recurrence rate, 3-year recurrence rate and metastasis rate of cancer cells in observation group were significantly lower than those in control group, 2-year survival rate and 3-year survival rate Rates were significantly lower than the control group; the difference between the two groups was statistically significant (P <0.05). Conclusion The clinical effect of pelvic and intraperitoneal hyperthermic perfusion chemotherapy for gastrointestinal cancer is exact, which can significantly prolong the overall survival of patients, reduce the metastasis of cancer cells and the total recurrence rate. It is safe to treat and does not increase the adverse reactions. It is clinically feasible.