妇科恶性肿瘤术中卵巢动脉灌注化疗

Perfusion chemotherapy through ovarian arteries during operation of gynecological malignant tumor

目的:探讨一种新的妇科恶性肿瘤介入化疗途径——术中卵巢动脉灌注化疗。方法:对包括卵巢癌、宫颈癌、子宫内膜癌在内的88例患者(化疗组)术中将5-Fu1000mg或MMc8mg稀释于40ml生理盐水中,缓慢注入两侧卵巢动脉;与同期收治的相应妇科恶性肿瘤手术患者88例(对照组)进行比较分析。结果:化疗组术后呕吐率(84. 1%)与对照组(55. 7%)相比差异有显著性(P<0 .01),但程度不重,经过止吐药物处理后很快恢复。化疗组术后自行排气时间及术后病率与对照组相比差异无显著性(P>0. 05)。卵巢上皮性癌患者化疗组和对照组术后CA125下降的总有效率分别为82. 8%和58 .6%(P<0. 05)。本组88例患者均未出现明显术后感染,无一例出现外周血白细胞下降和肝肾功能异常。结论:经骨盆漏斗韧带内的卵巢动脉血管通道进行动脉灌注化疗,是治疗妇科恶性肿瘤的可行方法。

Objective:To explore a new intervention chemotherapy of gynecological malignant tumor-intraoperative perfusion chemotherapy through ovarian arteries.Methods:88 patients with malignant tumor (chemotherapy group) including oophoroma, cervical carcinoma and endometrial carcinoma were slowly injected solution of 1 000 mg 5-Fu or 8 mg MMc diluted in 40 ml physiological saline into bilateral ovarian arteries, then the data were compared with those of 88 patients with corresponding tumors (control group) received treatment synchronously.Results:There was significant difference in postoperation vomit rate between chemotherapy group (84.1%) and control group (55.7%) ( P <0.01), but the vomit degree was not severe in chemotherapy group and could recover sooner after taking antemetic.There was not significant difference in average pass flatus time and postoperation incidence between chemotherapy group and control group ( P >0.05).Total effective rate of CA125 increase of patients with ovarian epithelial cancer in chemotherapy group and control group was 82.8% and 58.6%, respectively ( P <0.05).88 cases in chemotherapy group all had not obvious postoperation infections, none had peripheral blood leucocyte decrease and hepatic and renal function abnormity.Conclusion:Perfusion chemotherapy through ovarian arteries should be a feasible method for treatment of gynecological malignant tumor.