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目的:探讨腹腔内热灌注化疗治疗卵巢恶性肿瘤的安全性、稳定性及其疗效。方法:选取37例患有卵巢恶性肿瘤的患者,记录其术前血常规、CA125、肝肾功能,随机分术中同时行腹腔内热灌注化疗组13例(第一组),术后腹腔内直接放置化疗药物组12例(第二组),仅行手术治疗不进行局部化疗组12例(第三组),分别取其术前、术后腹水或腹腔冲洗液找肿瘤细胞;观察术后连续3天的最高体温、肛门排气时间及切口愈合情况,有无恶心、呕吐、腹腔内出血感染、化学性腹膜炎等并发症;术后1周血常规、术后2周肝肾功能、术后1、2周CA125的变化。结果:3组患者关腹前腹腔冲洗液中肿瘤细胞的差异有统计学意义(P<0.01),术后第1、2、3天最高体温差异无统计学意义(P>0.05),术后排气时间差异有统计学意义(P<0.05)。第一、二组患者术后出现恶心、呕吐差异有统计学意义(P<0.05);第一组患者术前、术后1、2周CA125水平比较差异有统计学意义(P<0.05),第二、三组术前、术后1、2周CA125水平比较差异无统计学意义(P>0.05);3组患者术后1周CA125下降率差异有统计学意义(P<0.05),术后2周CA125下降率差异无统计学意义(P>0.05)。结论:卵巢恶性肿瘤行肿瘤细胞减灭术并且行术中一次性腹腔内热灌注化疗可有效减少腹腔中游离肿瘤细胞,减少种植转移。
Objective: To investigate the safety, stability and efficacy of intraperitoneal hyperthermic perfusion chemotherapy in the treatment of ovarian cancer. Methods: Thirty-seven patients with malignant ovarian tumors were selected and their blood routine, CA125, liver and kidney function were recorded. Thirteen patients (the first group) received intraperitoneal hyperthermic perfusion chemotherapy at the same time randomly. 12 patients in the chemotherapy group (the second group) were treated with chemotherapy alone and 12 patients in the third group (no treatment group). The tumor cells were obtained by preoperative and postoperative ascites or peritoneal washings respectively. 3 days of the highest body temperature, anal exhaust time and incision healing, with or without nausea, vomiting, intra-abdominal hemorrhagic infection, chemical peritonitis and other complications; 1 week after surgery, 2 weeks after liver and kidney function, postoperative 1 , 2 weeks CA125 changes. Results: There were significant differences in tumor cells in peritoneal lavage before operation in the three groups (P <0.01). There was no significant difference in the maximum body temperature between days 1, 2 and 3 after operation (P> 0.05) Exhaust time difference was statistically significant (P <0.05). There was significant difference in nausea and vomiting between the two groups (P <0.05). There was significant difference in CA125 level between the first group and the second group after operation (P <0.05) There were no significant differences in CA125 levels between the second and third groups before and after 1, 2 and 3 weeks (P> 0.05). There was significant difference in CA125 decreasing rate among the three groups (P <0.05) There was no significant difference in the rate of CA125 after 2 weeks (P> 0.05). Conclusion: Ovarian malignant tumor cytoreductive surgery and intraoperative intraperitoneal heat perfusion chemotherapy can effectively reduce the free peritoneal tumor cells and reduce the metastasis.