结直肠癌术中腹腔内应用铜绿假单胞菌注射液疗效观察

Therapeutic effect observation of abdominal administration of pseudomonas aeruginosa preparation during the operation of colorectal cancer

目的研究结直肠癌患者术中腹腔喷洒铜绿假单胞菌注射液的安全性,并观察该给药方式对患者预后影响。方法选取2006年7月初至2007年10月我科室收治的经手术治疗的结直肠癌患者,将其分成两组,A组(对照组)行单纯手术治疗的患者119例,B组(治疗组)96例,术中腹腔应用铜绿假单胞菌注射液,观察术后患者体温、WBC(白细胞)数、肠蠕动恢复情况及腹腔引流量等指标。选取其中的III期和IV期结直肠癌患者,随访并进行回顾性分析。结果术后第三日各指标观察结果,体温高于37.5℃:治疗组为56.25%,对照组为54.62%(P>0.05);肠蠕动恢复情况:治疗组为51.04%,对照组49.58%(P>0.05);腹腔引流液大于50 ml:治疗组为16.67%,对照组18.49%(P>0.05);WBC数值:治疗组26.04%,对照组26.05%(P>0.05),所有患者无吻合口发生。生存曲线分析示III、IV期结直肠癌患者的中位生存期治疗组高于对照组(P>0.05);III期患者的3年生存率和5年生存率,治疗组分别为68.3%和39.0%,对照组分别为51.1%和25.5%(P>0.05),IV期患者3年和5年生存率均无显著差异。结论铜绿假单胞菌注射液在术中腹腔给药方式安全可行,该给药方式对结直肠癌患者术后肿瘤进展有一定抑制作用,但该作用对患者远期生存率无显著影响。

Objective Investigate the safety of abdominal local administration of pseudomonas aeruginosa preparation during operation of colorectal cancer .And observe the therapeutic effect after operation.Methods 119 patients with colorectal cancer taking operation alone in our hospital were selected as control .96 patients which were treated by pseudomonas aeruginosa preparation in abdominal cavity during operation were chosen as the intervention group .Investigate the change of body temperature ,recovery rate of the intestinal functions ,peritoneal drainage volum after operation .Chose the patients in Dukes C and Dukes D stage among the two groups to follow up and took retrospective analysis .Results Observed and recorded the incidence of adverse reaction within 3 days after operation.Incidence rate of body temperature over 37.5℃:control group was 54.62%while the intervention group was 56.25%(P>0.05).Recovery of the intestinal functions:control group was 49.59%and the treated group was 51.04%.Volume of peritoneal drainage more than 50 ml:control group was 18.49% compared with treated group was 16.67%.Growth of white blood cell:control group was 26.05% and treated group was26.04%.Survival curve analysis showed that median survival time of the treatment group was higher than control group (P>0.05)for stage III,IV patients.For patients in stage III,3 year-survival-rate and 5-year-survival-rate of treatment group were 68.3%/39.0%compared with control group which were 51.1%/25.5%(P>0.05).For patients in stage IV,there was no significantly difference between the two groups in survival rates .Conclusion The treatment of pseudomonas aeruginosa preparation administrated in abdominal cavity is safe and feasible .But it does not have significant effect on long-term survival rate .