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目的观察腹腔循环热灌注联合静脉化疗在胃癌合并腹腔积液的应用效果。方法将2010年1月~2012年8月收治的68例胃癌合并腹腔积液的患者根据患者和家属的意愿随机分成腹腔循环热灌注联合静脉化疗的观察组和单纯化疗的对照组。对照组采用单纯静脉化疗DCF方案静脉给药,三周为一疗程。观察组将DCF方案中DXT和5-Fu经静脉给药,三周为一疗程;将CDDP经腹腔行腹腔循环热灌注化疗,一周一次,四周为一疗程。结果腹腔循环热灌注联合静脉化疗组(38例)和单纯化疗组(30例)腹腔积液治疗有效率分别为71.05%和26.67%,(P<0.01);腹腔积液的复发率分别为31.57%和73.33%,(P<0.01);患者生活质量提高率分别为65.79%和26.67%,(P<0.01);不良反应发生率分别为44.73%和70%,(P<0.01),结果有显著性差异。结论腹腔循环热灌注联合静脉化疗不仅增加患者的治疗效果,减少肿瘤和腹腔积液的复发,提高患者的生活质量,而且还能减轻患者不良反应的发生率,安全有效,值得临床推广应用。
Objective To observe the effect of intraperitoneal hyperthermic perfusion combined with intravenous chemotherapy on gastric cancer with ascites. Methods Sixty-eight patients with gastric cancer complicated with ascites admitted from January 2010 to August 2012 were randomly divided into observation group treated with intraperitoneal hyperthermic perfusion combined with intravenous chemotherapy and control group with chemotherapy alone according to the wishes of patients and their families. Control group received intravenous chemotherapy alone DCF program, three weeks for a course of treatment. In the observation group, DXT and 5-Fu were administered intravenously in DCF regimen for three weeks for one course of treatment. CDDP was intraperitoneally injected into the peritoneal cavity through thermal perfusion chemotherapy once a week for four weeks. Results The effective rate of intraperitoneal hyperthermic perfusion combined with intravenous chemotherapy (38 cases) and chemotherapy alone group (30 cases) was 71.05% and 26.67%, respectively (P <0.01). The recurrence rates of ascites were 31.57 % And 73.33% (P <0.01). The improvement rates of patients’ quality of life were 65.79% and 26.67%, respectively (P <0.01). The incidences of adverse reactions were 44.73% and 70% Significant difference. Conclusion Intraperitoneal hyperthermic perfusion combined with intravenous chemotherapy not only increases the therapeutic effect of the patients, reduces the recurrence of tumor and ascitic fluid, improves the quality of life of patients, but also can reduce the incidence of adverse reactions in patients, which is safe and effective and worthy of clinical application.