直肠癌病人术中植入5-氟尿嘧啶缓释剂的安全性及疗效研究

Safety and immune effects of intra-abdominal implantation of sustained-releasing 5-fluorouracil in patients with rectal cancer

目的:探讨术中腹腔内植入5-氟尿嘧啶(5-FU)缓释剂对直肠癌病人的并发症发生率及免疫指标变化的影响。方法:实验组112例直肠癌病人行标准根治性手术,术中腹腔内植入缓释性5-FU;同期设对照组110例,予以单纯根治手术而不植入5-FU。术前及术后检测两组病人的肝肾功能、白细胞计数及免疫功能指标,比较术后并发症的发生情况及药物对机体免疫功能的影响。结果:两组病人术后的肝肾功能及白细胞计数指标无显著性差异(P>0.05)。实验组CD3+水平低于对照组(P<0.05);实验组术后切口感染发生率高于对照组(P<0.05);两组的其他术后并发症发生率无显著性差异(P>0.05)。结论:术中腹腔内植入5-FU缓释剂并未增加直肠癌病人的并发症发生率,且对机体免疫功能影响较小,具有较好的安全性,值得临床推广。

Objectives To study the change in the rate of postoperative complications and immune functions of patients with rectal cancer after intra-abdominal implantation of sustained-releasing 5-fluorouracil （5-FU）. Methods Sustained-releasing 5-FU were implanted intra-abdominally in 112 patients undergoing rectal cancer surgery in the experimental group, while 110 cases undering radical surgery only served as controls. The liver and kindney function, WBC counting, immune parameters were detected pre- and post-operatively, and postoperative complications were obselved. Results No significant differences of liver and kindney functions and WBC couting were detected between the two groups （P〉0.05）. Post-operative CD3^＋ level was lower in the experimental group than in the control group（P〈0.05）, with no significant difference in other immune parameters between the two groups （P〉0.05）. The incision infection rate was higher in the experimental group than in the control group （P〈0.05）. There was no significant difference when comparing the other postoperative complications and immune parameters levels. Conclusions Intra-abdominal implantation of sustained-releasing 5-FU during radical surgery of rectal cancer does not increase the rate of postoperative complications, and brings negligible influence to the immune functions of the patient.