动静脉插管体外循环顺铂加温灌注化疗下肢恶性肿瘤的保肢治疗研究

Study of the extrimites salvage surgery with Shubo and hyperthermia perfusion for limbs malignant tumors

目的：探讨顺铂加温灌注化疗对下肢恶性肿瘤的杀伤作用及其对保肢、提高５年生存率的价值。方法：体外循环机连接股动静脉插管，加入顺铂２００ｍｇ，持续加温灌注６０ｍｉｎ。灌注２至３周后行肿瘤大块切除或肿瘤骨段切除重建术。结果：疼痛消失，肿瘤缩小，关节功能改善。Ｘ线示肿瘤阴影缩小，边界清楚，密度增高；病理检查可见肿瘤细胞广泛坏死，胞浆和胞核消失。随访２２例，时间１个月至５年，平均２年３个月，无局部复发，肺部转移死亡２例，带肺转移瘤生存１例，无瘤生存１９例。结论：体外循环顺铂加温灌注化疗对肿瘤细胞具有很大的杀伤作用，可明显缓解局部疼痛，使肿瘤缩小，是保肢治疗的一个有效方法。

Purpose: to study the therapeutic efficacy of Shubo using isolation limb perfusion(ILP) with hyperthermia for malignant tumors Methods:23 patients received ILP The Shubo 200mg was injected in the arterial line, under hyperthermic conditions (42 to 43) for 60minutes Results:22 of 23 cases showed pain subsidence, tumor mass remission and joint motion improvement one patient died of kidney failure after ILP Necrosis of the tumour tissue occurred in 90%￣97% Twenty-two cases were followed up for 26 years(range, 1 to 60 months) In followed patients, twenty cases were alive(1 of 20 patient was alive with metastatic tumour of lung) and 2 cases died of metastatic tumour of lung none patient had recurrence of tumour Conclusion: this study suggested that Shubo and ILP for lower extrimites malignant tumors may achieve good efficacy under hyperthermic conditions(42 to 43)\=\ \