摘要
将４６例进展期胃癌患者在行根治性切除术后随机分为实验组（ｎ＝２５）和对照组（ｎ＝２１），两组患者的年龄、性别、癌肿侵及胃壁的深度及组织学类型等相似，且具有可比性。实验组在术毕立即用４３℃热低渗液（重蒸馏水）２５００～３０００ｍｌ腹腔内灌注，３０分钟后留灌注液７００～１０００ｍｌ于腹腔内，并于注入顺铂（６０～２００ｍｇ／ｍ２）的同时，静脉输入其解毒剂硫代硫酸钠（７．ｓｇ／ｍ２）。结果：实验组灌注前９例癌细胞阳性者，灌注后均转为阴性；与对照组相比，１年生存率前者为９６％，后者为４８．５４％，差异有显著性（Ｐ＜０．０１），但１年半生存率差异则无统计学意义（Ｐ＞０．０５）。该法具有胃肠道反应轻微，无严重肾、骨髓毒性反应和肝及周围神经损害，也无严重并发症等优点，值得进一步扩大例数，作更远期的疗效观察。
Forty-six patients with advanced gastric cancer were investigated. 25 patients wererandomized to receive intraperitoneal hyperthermic (43℃) hypotonic perfusion with high dose cis-diamminedichloroplatinum (60-200mg/m2 body surface) and sodium thiosulfate intraveneously (7. 5 g/m2body surface). The time of the intraperitoneal perfusion was 30 minutes with the total volume of theperfusate of 2500-3000ml. 21 patients were only operated. The sex, age macro-or microscopic serosalinvasion, and histologic type of two groups were similar and comparatible. We found no cancer cell innine patients with positive intraperitoneal free cancer cell in the treated group. The postoprative 1-yearsurvival rate of patients in the treated group (96. 00 % ) was significantly higher than that of the randomcontrol group (48. 54%), P< 0.01. The postoperative year survival rate in the treated group(68. 88% ) was also higher than that of the control group (40. 00% ),however,with no significant difference (P>0. 05 ). No serious myelosuppression, kindey, liver, and peripheral nerve damage, and othercomplications were found. The results indicated that this therapy is reasonably safe and could be a prophylactic therapy for the peritoneal recurrence after radical gastrectomy. which should be further investigated.
