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目的研究腹膜淋巴结转移癌诱发的肠梗阻应用肠系膜上动脉(superior mesenteric artery,SMA)灌注化疗的临床疗效.方法本文选取天津市第四中心医院2013-01-01/2016-12-01收治的腹膜淋巴结转移癌诱发肠梗阻患者94例进行研究,采用随机数表法将患者分为观察组和对照组各47例,对照组患者给予肠梗阻常规治疗,观察组患者给予SMA灌注化疗,比较两组患者治疗后临床疗效,临床症状缓解时间、不良反应发生率以及生存时间.结果观察组患者治疗后总有效率明显高于对照组(91.49%v s 76.60%),组间比较差异有统计学意义(P<0.05);观察组患者恢复排气时间(4.54 d±1.26 d vs 8.27 d±2.39 d)、恢复排便时间(2.67 d±0.61 d vs5.24 d±1.05 d)以及腹胀、腹痛缓解时间(4.61 d±1.26 d vs 8.27 d±2.35 d)均明显短于对照组,观察组患者肠道通畅维持时间明显长于对照组(111.25 d±32.58 d vs 28.35 d±6.41 d),组间比较差异有统计学意义(P<0.05);观察组患者不良反应发生率明显低于对照组(8.51%vs 23.40%),两组对比差异有统计学意义(P<0.05);观察组患者治疗后生存时间为明显长于对照组(5.28 mo±1.16 mo vs 2.15 mo±0.86 mo),对比差异有统计学意义(P<0.05).结论腹膜淋巴结转移癌诱发的肠梗阻应用SMA灌注化疗临床疗效显著,可降低不良反应的发生率,改善患者临床症状恢复时间,促进患者的恢复,值得临床推广应用.
Objective To study the clinical efficacy of superior mesenteric artery (SMA) infusion chemotherapy for intestinal obstruction induced by peritoneal lymph node metastasis. Methods The peritoneum treated at the Fourth Central Hospital of Tianjin from January 2013 to January 2016 was selected. 94 cases of intestinal obstruction induced by lymph node metastasis were studied. Random number table method was used to divide the patients into observation group and control group each with 47 cases. Control group patients were given routine treatment of intestinal obstruction, and observation group patients were given SMA perfusion chemotherapy. Clinical efficacy, clinical symptom remission time, incidence of adverse reactions, and survival time of patients after treatment. Results The total effective rate of patients in the observation group after treatment was significantly higher than that of the control group (91.49% vs 76.60%), and the difference between the groups was statistically significant ( P<0.05); Recovery time of the patients in the observation group (4.54 d±1.26 d vs 8.27 d±2.39 d), duration of defecation (2.67 d±0.61 d vs 5.24 d±1.05 d), and abdominal distention and abdominal pain relief time (P < 0.05). 4.61 d±1.26 d vs 8.27 d±2.35 d) were significantly shorter than those in the control group. The duration of intestinal patency in the observation group was significantly longer than that in the control group (111.25 d±32.58 d vs 28.35 d±6.41 d). There was a significant difference between the groups. statistics Yi (P<0.05); The incidence of adverse reactions in the observation group was significantly lower than that in the control group (8.51% vs 23.40%), and the difference between the two groups was statistically significant (P<0.05); the survival time of the observation group was significantly after treatment Longer than the control group (5.28 mo±1.16 mo vs. 2.15 mo±0.86 mo), the difference was statistically significant (P<0.05). Conclusions Peritoneal lymph node metastasis-induced intestinal obstruction is significantly improved by the use of SMA perfusion chemotherapy, which can reduce adverse reactions. The incidence of improvement of clinical symptom recovery time, and promote the recovery of patients, is worthy of clinical application.