持续恒温循环热灌注治疗腹腔恶性积液的临床研究

The clinical study of using continuous homeothermia circulation perfusion to treat malignant hydrops

目的探讨恶性腹腔积液采用腹腔恒温(42～43℃)持续循环热灌注化疗的疗效。方法45例恶性腹水患者随机分为两组。观察组22例采用常规穿刺针建立循环双通道,先予腹腔冲洗置换腹腔灌注液体,最后保持2500～3500ml,腹腔恒温(42～43℃)循环开始3～5min后,在管路中加入DDP40mg,持续恒温循环60min热化疗;治疗结束放出治疗液,保持腹腔内存留1000～1500ml。对照组23例置腹腔引流管,先予腹腔冲洗,后灌注1000～1500ml加有化疗药物DDP40mg的液体;对照组灌注药液入腹前均加温至43℃。结果观察组总有效率86.3%,明显高于对照组(P<0.05)。结论与传统的置管抽水热灌注化疗比较,腹腔内持续恒温循环热化疗明显提高了恶性腹腔积液治疗的有效率,同时在控制恶性积液的回潮方面也有明显提高,改善了癌症晚期患者的生存质量。

Objective To discuss the therapeutic efficacy of using continuous homeothermia（42 - 43℃ ）circulation perfusion chemotherapy to treat malignant hydrops. Methods 45 cases with malignant hydrops were divided into two groups randomly. Double circulation channels were established by using routine puncture needles in the treatment group. After the irrigation of peritoneal cavity and replacement ,2500 -3500 ml liquid was left 1000 -1500 ml. DDP 40 mg was perfused after circulation had begun for 3 - 5 min, then continuous hyperthermic perfusion chemotherapy was circulated for 60 min. After treatment, 1000 -1500 ml liquid was.left 1000 - 1500 ml. The 23 patients in the control group were perfused the same dose DDP after they were catheterized,drained and flushed. In the control group,the drug was heated to 43℃ before perfusing into the abdominal cavity. Results The total effective rate of the treatment group （86.3%） was obviously higher than that of the control group （ P 〈 0.05）. Conclusion Compared with the traditional methods, the continuous hyperthermic perfusion circulation can not only improve the effective rate of treating malignant hydrops, but also reduce the recurrence of malignant hydrops and improve the patients＇ life quality.