希罗达联合高频热疗和腹腔热灌注化疗治疗老年恶性腹腔积液临床观察

Clinical observation of Xeloda combined with intraperitoneal thermal perfusion chemotherapy and high-frequency hyperthermia for treatment of the old patients with malignant ascites

目的 观察希罗达联合高频热疗和腹腔热灌注化疗治疗老年恶性腹腔积液的近期疗效、临床受益率和副反应。方法 采用中心静脉导管以腹穿术行腹腔内置管,进行持续腹腔引流,引流量1500～2000 ml/d,引流5～10 d,最大限度引尽腹水后,经中心静脉导管快速注入含顺铂、地塞米松的43℃无菌蒸馏水200 ml,嘱患者每15min变换一次体位,随后用高频热疗机给患者行腹部热疗,设定治疗温度43℃,持续1 h,第2天打开引流管,引流残留腹水,待腹水引流尽后再行热灌注化疗和高频热疗。热灌注化疗2～4次;高频热疗每2～3 d一次,共进行5次热疗。从治疗第一天起口服希罗达2000～2500 mg/（m2.d）,bid,d1～14,休息7d,21 d作为一周期。如效果不佳,可再进行下一周期治疗。结果患者治疗后总有效率87.5%,临床受益率为90.6%。治疗副反应主要为骨髓抑制和消化道症状。结论 希罗达联合高频热疗和腹腔热灌注化疗治疗老年恶性腹腔积液,疗效确切,患者可耐受。

Objective To evaluate the efficacy and toxicity of Xeloda combined with intraperitoneal thermal perfusion chemotherapy and high-frequency hyperthermia in treatment of the old patients with malignant ascites. Methods Thirty-two old patients with malignant ascites received the following treatment：intra- peritoneal infusion of 43℃ distilled water 200 ml containing DDP and Dex,followed by treatment with highfrequency hyperthermia machine （ HG-2000 ） for 1 hour every three days, and at the same time, every old patient took orally Xeloda 2000-2500 mg/（m^2· d） ,bid,from the first day to 14th day. Results The total response rate was 87.5% and the clinical benefit rate was 90.6%. The main toxicity was bone marrow sup- pression and gastroenteric symptoms. Conclusion Xeloda combined with intraperitoneal thermal perfusion chemotherapy and high-frequency hyperthermia is well tolerated and effective in treatment of the old patients with malignant ascites.