开放式腹腔内短时超高温化疗对手术患者的影响

The effect of open transient hyperthermia combined with chemotherapy on patients with digestive tract cancer

目的 观察４７℃，２０ 分钟腹腔内热疗对患者的影响，建立开放式腹腔内短时超高温化疗的方法。寻求适合临床应用的简便疗法。方法 在２９ 例进展期胃肠道肿瘤患者行根治术后，将４８～５０ ℃的蒸馏水灌入腹腔或盆腔，保持腹腔或盆腔内水温４５ ～４７℃，维持２０ 分钟，再将５ － ＦＵ１ ０００ ｍｇ 注入。检测患者腋下体温、血压、心率、呼吸、肝肾功能、血常规、手术后腹腔引流量，并与常规对照组２２ 例患者比较。结果 在此过程中，两组患者的体温、生命体征、肝肾功能均无明显变化（Ｐ＞０ ．０５）。超高温化疗组的日平均腹腔引流量明显少于常规对照组，二者比较，Ｐ＜ ０ ．０５。两组患者手术后均恢复良好，胃肠道功能在手术后第３ ～４ 天恢复，腹部伤口均甲级愈合，未出现肠瘘，伤口感染，腹泻及其他并发症。结论 ４５ ～４７ ℃，２０ 分钟开放式腹腔内短时超高温化疗，勿需体外降温，其方法简便、易行，无明显不良反应。

Objective To observe the effect of intraperitioneal thermal therapy 47℃,20min on patients with digestive tract cancer(DTC) and to establish the method of open transient hyperthermia combined with chemotherapy.Methods In 29 patients with DTC,48-50℃ distilled water was perfused into abdominal cavity or pelvic cavity to keep the temperature 45～47℃ for 20 min after operation.Then 5-FU 1 000 mg was injected into abdominal cavity.The changes of body temperature,blood pressure,heart rate,liver or kidney function,and abdominal drainage were recorded and compared with those of the 22 patients without intraperitoneal thermo-chemotherapy.Results There was no significant change in the patients' temperature,blood pressure,heart rate,breath rate,liver and kidney functions in both groups(P>0.05).The volume of abdominal drainage in patients of test group was significantly decreased compared with the control group.(P<0.05).No complications occurred in both groups.Conclusion It is showed that transient intraperitoneal thermo-chemotherapy was convenient,and it is easy to master and no obvious side effects are found.