香菇多糖联合氟尿嘧啶植入剂治疗大肠癌患者的临床研究

Clinical study of lentinan combined with fluorouracil implants on patients with colorectal cancer

目的探讨香菇多糖联合氟尿嘧啶植入剂治疗大肠癌患者的临床效果和安全性。方法82例行经腹结直肠癌根治术的大肠癌患者随机分为2组。术中在癌床和淋巴结引流途径及系膜血管走行方向多点植入氟尿嘧啶植入剂,治疗组术后第1,2,3天静脉滴注香菇多糖。观察2组免疫指标的变化,伤口愈合情况,吻合口瘘发生率,肠梗阻、腹膜炎和肝肾功能的变化,通过Karnofsky评分增高率判断生活质量改善的情况。结果术后第4天治疗组CD4+、CD4+/CD8+较对照组明显升高,CD8+则明显下降,有显著性差异(P均<0.05)。Karnofsky评分增高率2组间比较有显著性差异(P<0.05)。2组术后腹腔并发症和毒副反应比较无显著性差异。结论大肠癌术中腹腔内应用氟尿嘧啶植入剂对患者免疫功能有一定的影响,香菇多糖能够改善患者免疫功能,2组术后并发症的发生率未见增高,具有较好的安全性。

Objective It is to observe the clinical efficacy and safety of lentinan combined with fluorouracil implants on patients with colorectal cancer.Methods 82 patients with advanced colorectal cancer were randomly divided into control group and treatment group.The tumor was surgically removed and sustained-release fluorouracil was implanted multiple point during operation.The treatment group received lentinan in the first day to the third day after operation by intravenous drip.The changes of immune functions,incidence of anastomosis leakage,intestinal obstruction and peritonitis,liver and kidney function were observed in both groups,and the quality of life improvement were determined by Karnofsky score higher rate after treatment.Results Compared with the control group after 4 days of treatment,the value of CD4＋ and CD4＋/CD8＋ were significantly increased,and CD8＋ was significantly decreased in treatment group,there were significant differences（P0.05）.There was significant difference in Karnofsky score higher rate after treatment between both groups（P0.05）.There was no significant difference in abdominal complications and side effect between both groups.Conclusion The peritoneal implantation of 5-FU in colorectal surgery has considerable influence on the immune function.Lentinan can improve the immune function of patient after operation.The incidence of complications is not higher with better security.