直肠癌术中直肠上动脉灌注雷替曲塞化疗的安全性研究

Safety research of colorectal cancer intraoperative rectal artery perfusion chemotherapy by Raltitrexed

目的探讨直肠癌根治术中选择性直肠上动脉灌注雷替曲塞化疗的安全性。方法将172例行直肠癌根治术患者分为灌注化疗组(83例)和对照组(89例)。对照组采用常规开腹手术治疗,灌注化疗组在常规开腹手术治疗基础上于术中经直肠上动脉灌注雷替曲塞。评价两组患者术后各系统的毒性反应、并发症以及两组患者手术前后血白细胞(WBC)、红细胞(RBC)、血小板(PLT)、尿素氮(BUN)以及丙氨酸氨基转移酶(ALT)的变化情况。结果灌注化疗组术后的各系统的毒性反应、并发症与对照组比较,差异无统计学意义(P>0.05);两组患者手术前后WBC、RBC、PLT、BUN及ALT均无明显变化,两组比较,差异无统计学意义(P>0.05)。结论雷替曲塞作为水溶性胸苷酸合成酶(TS)的特异性抑制剂,能通过还原型叶酸甲氨蝶呤细胞膜载体被细胞主动摄取,在细胞内代谢成多种聚合谷氨酸而长时间发挥抗肿瘤作用。本研究证明直肠癌根治术中经直肠上动脉灌注雷替曲塞是安全可行的方法。

Objective To explore the safety of rectal cancer radical mastectomy on selective rectum arterial infusion chemotherapy by Raltitrexed. Methods 172 patients with colorectal cancer radical mastectomy were divided into per- fusion chemotherapy group （83 cases） and control group （89 cases）. The control group used the conventional open surgery treatment, the peffusion chemotherapy group on the basis of the contrlo group was given the rectum arterial perfusion Raltitrexed in operation. The postoperative evaluation of each system toxic reaction, complications and before and after surgery blood white blood cell （WBC）, red blood cell （RBC）, platelet （PLT）, urea nitrogen （BUN） and alanine aminotransferase （ALT） changes in two groups were evaluated. Results Postoperative of each system toxic reaction and complications in peffusion chemotherapy group compared with control group, the difference was statistically significant （P 〉 0.05）; WBC and RBC, PLT, BUN and ALT before and after surgery in the two groups were not significantly changed, the difference was statistically significant in the two groups （P 〉 0.05）. Conclusion Rahitrexed as water solu- ble thymidylic acid synthase （TS） specific inhibitors, can through the reduced folie acid methotrexate cell membrane by carrier cells actively absorb, inside the cell metabolism into various polymerization glutamic acid and long time play antitumor effect. The study proves the rectum cancer radical mastectomy in artery peffusion ray for song plug, it is a safe and feasible method.