腹腔温热灌注化疗的安全性实验研究

Experimental study of reliability and feasibility of intraperitoneal hyperthermic chemotherapy

目的 探讨腹腔温热灌注化疗的安全性和可行性。方法 将 2 4只新西兰大白兔随机分成 4组 ,每组 6只。A组 (腹腔温热灌注化疗组 ) ,B组 (腹腔温热灌注组 ) ,C组 (腹腔常温灌注化疗组 ) ,D组 (单纯手术组 )。观察术中生命体征及术后血常规、肝功、肾功变化、腹腔粘连情况以及肝脏、肾脏、脾脏、吻合口组织的病理学改变。测定A、D组吻合口破裂压。结果 A、B组兔呼吸、脉搏、动脉血压在灌注过程中有增快和升高 ,但均未超出正常范围。白细胞及红细胞的变化各组间并无显著差异 (P >0 0 5 ) ,A组血小板有轻度减少 ,并与其余各组相差显著 (P <0 0 5 )。尿素氮变化仅C组与其余各组相差显著 (P <0 0 5 ) ,有轻度增高 ,而肌酐变化各组间无明显差异 (P >0 0 5 )。A、B、C组腹腔粘连的程度较D组为轻。A、D组吻合口破裂压无显著性差异 (P >0 .0 5 )。结论 腹腔温热灌注化疗不会对兔造成严重影响 ,是安全和可行的。

Objective To evaluate the safety of intraperitoneal hyperthermic chemotherapy. Methods Twenty four New Zealand rabbits were randomly divided into four groups: group A (intraperitoneal hyperthermic chemotherapy group), group B (intraperitoneal hyperthermic perfusion group), group C (intraperitoneal normothermic chemotherapy group), and group D (operation group). Vital signs of the rabbits were observed during the operations, and blood routine, liver function, and renal function of the rabbits were measured postoperatively. Intraperitoneal adherence and pathologic changes of the livers, kidneys, spleens, and tissues of stoma were observed. Bursting pressure of the stomas was measured in groups A and D. Results The breath, pulse, and arterial blood pressure increased in rabbits in groups A and B, but all were in normal ranges. There was no significant difference in changes of WBC and RBC between the four groups (P>0.05). Platelet decreased significantly in group A (P<0.05), and BUN increased significantly in group C (P<0.05). Intraperitoneal adherence was more obvious in group D. There was no significant difference in bursting pressure of stomas between groups A and D. Conclusion Intraperitoneal hyperthermic chemotherapy, resulting in no harm to rabbits, is safe and feasible.