腹腔恒温循环热灌注化疗治疗癌性腹水的疗效

Effect of continued circulatory hyperthermia perfusion of abdominal cavity on the malignant ascites

目的:探讨癌性腹水采用恒温(42～43℃)持续循环热灌注化疗的临床效果。方法:56例癌性腹水患者随机分为两组。观察组28例采用常规穿刺留置一次性导管建立循环双通道,先予腹腔冲洗置换腹腔灌注液体,最后保留液体2 500～3 000ml,腹腔恒温(42～43℃)循环开始3～5min后,在管路中加入卡铂300mg的液体,持续恒温循环60min热化疗,治疗结束放出治疗液,留液1 000～1 500ml。对照组28例置腹腔引流管,先予腹腔放液,后灌注1 500ml加有卡铂300mg的液体。结果:观察组有效率89.3%,对照组有效率53.6%,差异有统计学意义(P<0.05)。结论:与传统的置管抽水灌注化疗比较,腹腔内持续循环热灌注化疗明显提高了癌性腹水治疗的有效率,同时在控制癌性腹水的回潮方面也有明显提高,改善了癌症晚期患者的生存质量且方法便于掌握。

Objective： To investigate the clinical effect of continued circulatory hyperthermia（42-43 ~C） perfusion of abdominal cavity on the malignant ascites. Methods： 56 patients with malignant as- cites were randomly and equally divided into the observation group and the control group. Cyclic dual channels were established in the observation group by adopting the conventional puncture and the indwelling disposable catheters. First, the abdominal cavities of the patients were flushed, then the intraperitoneal perfusion liquid was replaced, and lastly 2 500-3 000 ml intraperitoneal fluid were retained. 3 to 5 minutes after the beginning of the circulation under constant temperature （42- 43 ~C） of the abdominal cavities, 300rag carboplatin liquid were added into the drainage tubes of the patients to have 60 mins＇ hyperthermic chemotherapy under constant temperature. After the treatment, the treatment liquid were emitted and only 1 000-1 500 ml liquid were remained. While in the control group, drainage tubes were placed in the abdominal cavities of the patients. First the liquid of the intraperitoneal fluid were discharged, and then 1 500 ml liquid containing 300mg carboplatin were perfused into the cavities through the tubes. Results. The respective effective rate of the observation and the control group was 89.3% and 53.6%, which was of statistical difference （P〈0. 05）. Conclusion. Compared with the conventional ble catheters, the continued circulatory hyperthermia perfusion chemotherapy by indwelling disposaperfusion of abdominal cavity can improve the curative effect onmalignant ascites more obviously, can obviously control of the resurgence of cancerous ascites and improve the survival qualities of the patients. Also, the method is easy to master.