胃肠道肿瘤术中恒温腹腔热灌注化疗的近期疗效观察（附40例报告）

Recent clinical observation of homoiothermal continuous hyperthemic peritoneal perfusion chemotherapy after operation in gastrointestinal cancer（40cases reported）

目的：观察胃肺道肿瘤术中使用恒温腹腔热灌注化疗机进行治疗的可行性、安全性、并发症和近期抗癌效果。方法：对40例结直肠癌、胃癌进行根治性手术或姑息切除后，患者仍在麻醉状态下即置管进行腹腔热灌注化疗，化疗液为生理盐水（保持水温42℃）3000ml＋5-FU2．0。结果：术中腹腔热灌注化疗成功率为100％，热化疗时间内腹腔内化疗液温度均可达到41～43℃，并恒定保持60--90rain。热灌注化疗期间患者生命体征无明显异常，除暂时性发热外无其它不适，大肠癌患者发生肠瘘1例，腹腔少量出血2例，切口愈合延迟1例，无其它明显毒副作用及并发症。10例腹水患者缓解率为90％（9／10）。随访率100％，随访7～21个月。肝转移2例，肝转移率5％，其中腹腔转移1例，盆腔转移2例，局部复发率为7．5％。大肠癌患者中有1例在术后9个月死于全身广泛转移。结论：术中进行腹腔热灌注化疗方便安奎，并发症少，有利于杀灭腹腔内残余微小癌灶和脱落的游离癌细胞；且惑者仍处于麻醉状态，避免了热灌注带来的腹胀等不良体验。

Objective：To observe the safety and recent anti--cancer effect of homoiothermal continuous hyperthemie peritoneal perfusion （CHPP） chemotherapy after operation in gastrointestinal cancer. Methods： 40 patients of gastrointestinal cancer for radical surgery or palliative resection, the pa- tient still under anesthesia the catheter for intraperitoneal chemotherapy, Chemotherapy liquid the saline solution （to maintain water temperature 42 ℃ 3000ml ＋5-- FU 2.0g. Results： Intraoperative homoiothermal continuous hyperthemic peritoneal perfusion ehemotherapy rate 100%. Perfusion fluid temperature can achieve 41--43 ℃, and maintain constant 60 -- 90min. Patients have normal life signs during hot perfusion chemotherapy, except for the temporary fever without other unwell. One case occurred large intestine fistula , Two eases celiac bleeding , One ease healing delay incision. Ten cases of patients with ascites ease rate is 90 ~ （9/10）. Follow--up rate is 100 %, 7-- 21 months follow--up. Liver metastases 2 cases, liver metastasis rate of 5 e~. One case with celiac metastasis, 2 eases with pelvic transfer,local recurrence rate is 7.5~/~. One patient with eolorectal cancer died widespreadmetastasis in nine months after surgery. Conclusion： Intraoperative homoiothermal continuous hyperthemic peritoneal perfusion chemotherapy eonvenient safety, less complications, to kill intra--abdominal residual tiny cancer ceils and free cancer cells. Patients stilt in anesthesia, avoid abdominal distension and other bad experiences.