大肠癌术中腹腔植入缓释氟尿嘧啶的临床评价

Clinical evaluation of intraperitoneal interstitialimplant with sustained - release fluorouracil during operation for advanced colorectal cancer

目的探讨进展期大肠癌术中腹腔植入缓释氟尿嘧啶的安全性及疗效，寻找预防大肠癌局部复发转移的新途径。方法64例行结直肠癌根治术患者，分成术中植入缓释氟尿嘧啶组（治疗组）和对照组，治疗组在瘤床和沿淋巴引流途径分多点植入缓释氟尿嘧啶，观察两组术后切口愈合情况，有无吻合口漏、肠梗阻、腹膜炎和肝肾功能变化，腹腔复发或肝转移等。结果治疗组与对照组术后出现吻合口漏、肠梗阻、腹膜炎以及肠功能恢复时间差异均无统计学意义（P〉0．05），两组术后白细胞计数、丙氨酸氨基转移酶和肌酐较术前有明显增高（P〈0．05），但两组间差异无统计学意义（P〉0．05）。治疗组腹腔复发和肝转移率较对照组低（P〈0．05）。结论结直肠癌术中腹腔植入缓释氟尿嘧啶是安全的，具有良好的耐受性，是预防术后复发转移的有效途径。

Objective To explore the new- safety and effective way to prevent the local recurrence of advanced colorectal cancer after operation. Methods Sixty four patients with advanced color- ectal cancer were randomly divided into control group and sustained - release fluoroura＇cil group. The tumor was surgically removed and sustained - release fluorouracil were implanted muhiple point during operation in the tumor cavity to observe the incidence of wound infection, anastomosis leakage, intestinal obstruction and peritonitis. WBC. RBC. ALT and Cr. local recurrence rate and metastasis rate were also observed. Results The difference of side effects and postoperative complications between controlled group and sustained -release fluorouracil group was not obviously. WBC. ALT and Cr were different before and after operation, but the differences of two groups were not obviously. The local recurrence and metastasis rate between control group and sustained -release fluorouracil group were obviously. Conclusions The way of intraperitoneal interstitialimplant with sustained - release fluorouracil during operation for advanced coloreetal cancer is safe. and it might become a new effective method to prevent postoperative local recurrence of colorectal cancer.