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目的探讨顺铂与紫杉醇不同给药途径在晚期卵巢癌治疗中的临床疗效与安全性。方法选取2009年10月—2011年3月收治的90例晚期卵巢癌患者,随机分为对照组和观察组每组45例,对照组患者首先给予静脉注射紫杉醇,24 h后静脉注射顺铂;观察组患者首先进行静脉注射紫杉醇,24 h腹腔注射顺铂,第8天时腹腔注射紫杉醇。治疗3周为1疗程,治疗3个疗程后观察临床疗效及不良反应。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组总有效率(86.67%)明显高于对照组(62.22%),差异有统计学意义(χ2=7.067,P<0.05);观察组的不良反应发生率均比对照组的要高,其中观察组的白细胞减少和血红蛋白减少的发生率分别为84.44%和57.78%,而对照组的白细胞减少和血红蛋白减少的发生率分别为42.22%和28.89%,差异均有统计学意义(χ2=17.273、7.647,均P<0.05);观察组患者的无进展生存期和中位生存期均显著高于对照组,差异均有统计学意义(t=17.330、13.402,均P<0.05);且观察组患者的1年生存率和3年生存率也明显高于对照组,差异均有统计学意义(χ2=3.850、4.447,均P<0.05)。结论顺铂联合紫杉醇治疗晚期卵巢癌,经腹腔灌注治疗的临床效果比静脉滴注效果好,能明显延长患者生存时间,不良反应发生率较高,但在患者可接受范围内,值得在临床上大力推广。
Objective To investigate the clinical efficacy and safety of different routes of administration of cisplatin and paclitaxel in the treatment of advanced ovarian cancer. Methods Ninety patients with advanced ovarian cancer who were admitted from October 2009 to March 2011 were randomly divided into control group and observation group with 45 cases in each group. Patients in control group were given intravenous paclitaxel intravenously and cisplatin intravenously 24 hours later. Patients in the observation group were given intravenous paclitaxel intravenously and cisplatin intraperitoneally 24 hours later, and paclitaxel was injected intraperitoneally on the 8th day. Treatment for 3 weeks for a course of treatment, after 3 courses of treatment observed clinical efficacy and adverse reactions. Measurement data using t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The total effective rate (86.67%) in the observation group was significantly higher than that in the control group (62.22%), the difference was statistically significant (χ2 = 7.067, P <0.05). The incidence of adverse reactions in the observation group was higher than that in the control group The incidences of leukopenia and hemoglobin in the observation group were 84.44% and 57.78% respectively, while the incidences of leukopenia and hemoglobin in the control group were 42.22% and 28.89%, respectively, with statistical significance (χ2 = 17.273 , 7.647, all P <0.05). The progression-free survival and median survival of the observation group were significantly higher than those of the control group (t = 17.330, 13.402, all P <0.05) The 1-year survival rate and 3-year survival rate of patients in group A were also significantly higher than those in control group (χ2 = 3.850, 4.447, both P <0.05). Conclusion Cisplatin combined with paclitaxel in the treatment of advanced ovarian cancer, the clinical effect of intraperitoneal perfusion is better than intravenous drip, which can significantly prolong the survival time of patients, the incidence of adverse reactions is higher, but within the acceptable range of patients, it is clinically worth Promote.