体腔循环热灌注化疗的安全性实验研究

Experimental Study on the Safety of Abdominal Cavity Circulatory Thermal Perfusion

目的:观察体腔循环热灌注化疗(Cavity circulatorythermal perfusion,CCTP)中不同温度对实验犬生命体征和腹腔各脏器的影响,明确实验动物CCTP的适宜温度。方法:以犬为实验动物,分别于其腹腔温度41、42、43℃时进行指标检测。对每组动物进行CCTP,化疗药物为顺铂,每次流速140mL/min治疗持续60 min,每隔2 d重复1次,共3次。在每次CCTP前及24 h后抽取外周血备检。CCTP 3次后24 h及2周时每组分别处死2只犬,观察内脏器官形态学改变,进行肝、肾等脏器病理检查。结果:41、42C温度,流速140mL/min下3次CCTP对犬的生命体征及肝肾功无明显影响;43℃腹腔温度流速140mL/min行3次CCTP后对犬生命体征及肝肾功有不同程度的影响,肝、肾、脾及肠组织表现出病理损伤。结论:42℃、流速140mL/min以下腹腔温度联合顺铂3次CCTP、每次60 min是安全的,可作为CCTP联合化疗的治疗温度;43℃同条件下对犬的生理功能有损害,不适合作为CCTP联合化疗的治疗温度。

Objective：This work investigated the effect of cavity circulatory thermal perfusion （CCTP） on the vital signs and im -portant organs of the experimental animal dogs at different temperatures. The study likewise aimed to determine the optimal tempera-ture for chemotherapy. Methods：Dogs were used as the experimental animal models for CCTP. CCTP was performed with cisplatin us -ing a hyperthermic intraperitoneal treatment system at 41°C, 42°C, and43°C （one course of clinical treatment）. The hepatic and renal functions were detected in preserved blood samples before CCTP and at 24h after each course of the treatment. The respective morpho -logical and pathological changes of the major abdominal organs were likewise studied at 24h as well as 2 weeks after the third course of CCTP. Results：The three courses of CCTP with a perfusion rate of 140 mL/min at41or 42°C did not have any observable negative effects on the hepatic and renal functions of experimental animals. On the other hand, the three courses of CCTP with a perfusion rate of 140 mL/min at43°C had a significant negative effect on the hepatic and renal functions, with histopathological injuries in the liver, kidney, spleen, and intestines. Conclusion：CCTP with a perfusion rate of 140 mL/min combined with cisplatin chemotherapy （three times / 60min） was safe and feasible at 42°C, but could damage visceral organs of experimental animals at 43°C.