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目的探讨进展期胃癌根治术后腹腔温热灌注化疗的疗效。方法选取进展期胃癌患者30例,分为灌注组、对照组,每组15例。两组患者均行腹腔镜下胃癌根治术,术后常规静脉化疗。灌注组术后给予顺铂100mg/m~2+氟尿嘧啶500mg/m~2+生理盐水4000ml,以BR-TRG-Ⅱ型热灌注机行腹腔温热灌注化疗,共灌注3次,每次灌注间隔时间>24h。观察两组手术并发症、化疗不良反应、术后3年患者复发及生存情况。结果术后,灌注组发生切口感染1例;对照组发生切口感染、吻合口瘘各1例;两组术后并发症差异无统计学意义(P>0.05)。化疗后,灌注组出现恶心呕吐、腹痛、WBC减少各1例;对照组出现恶心呕吐2例,腹痛、WBC减少各1例;两组化疗不良反应差异无统计学意义(P>0.05)。术后3年,灌注组复发2例,生存13例;对照组复发6例,生存9例;灌注组复发比例低,生存比例高,与对照组比较,差异有统计学意义(P<0.05)。结论对于进展期胃癌,根治术后腹腔温热灌注化疗可有效控制复发,提高患者生存率。
Objective To investigate the efficacy of intraperitoneal hyperthermic perfusion chemotherapy after radical gastrectomy for advanced gastric cancer. Methods Thirty patients with advanced gastric cancer were selected and divided into perfusion group and control group. There were 15 cases in each group. Both groups underwent laparoscopic radical gastrectomy and conventional intravenous chemotherapy. In the infusion group, cisplatin 100 mg/m~2+ fluorouracil 500 mg/m~2+ saline 4000 ml was administered postoperatively. The BR-TRG-II type hyperthermic perfusion machine was used for intraperitoneal hyperthermic perfusion chemotherapy with 3 times perfusion interval. Time> 24h. Observed two groups of surgical complications, adverse reactions to chemotherapy, recurrence and survival of patients after 3 years. Results One postoperative incision infection occurred in the perfusion group. One incision infection and one anastomotic fistula occurred in the control group. There was no significant difference in postoperative complications between the two groups (P>0.05). After chemotherapy, nausea and vomiting, abdominal pain, and WBC decreased in 1 case in the infusion group, 2 cases in the control group, 1 in abdominal pain and WBC, and there was no significant difference in adverse drug reactions between the two groups (P>0.05). At 3 years after operation, 2 cases relapsed in the infusion group and 13 survived; 6 cases relapsed in the control group and 9 cases survived; the recurrence rate in the perfusion group was low, and the survival rate was high, compared with the control group, the difference was statistically significant (P<0.05). . Conclusion For advanced gastric cancer, postoperative intraperitoneal hyperthermic perfusion chemotherapy can effectively control recurrence and improve the survival rate of patients.