腹腔热灌注化疗对妇科癌性腹水的疗效观察

Clinical study of intraperitoneal hyperthermic perfusion chemotherapy in the treatment of gynecological malignant seroperitoneum

目的:评价腹腔热灌注化疗对妇科癌性腹水治疗的临床价值。方法:对49例晚期妇科恶性肿瘤合并癌性腹水患者,使用深静脉软管经皮腹腔内置管,经体外循环热灌注治疗后,注入顺铂,观察恶性腹水量的变化。同时检测腹水中的相关肿瘤标志物的变化情况。观察患者一般生活体力状况变化及生活质量情况。结果:行腹腔热灌注化疗后,11例患者腹水减少程度>90%,28例患者腹水减少程度>50%,总有效率79.59%。18.36%的患者发生恶心及呕吐等症状。治疗后患者一般生活状况评分、腹水最大直径等指标较治疗前好转(P<0.01),肿瘤标志物水平均明显低于治疗前(P<0.05)。结论:腹腔热灌注化疗治疗妇科癌性腹水近期疗效好且安全,副作用小,患者耐受性好,是恶性腹水患者较可靠的治疗措施。

Objective：To explore the effects and side effects of intraperitoneal hyperthermal chemotherapy in the treatment of malignant seroperitoneum in gynecology carcinoma. Methods： Total of 49 cases diagnosed as gynecology carcinoma with malignant seroperitoneum, received intraperitoneal hyperthermal chemotherapy combining with DDP. To observe the change in volume of seroperitoneum, and test tumor markers （ CEA, CA125, CA242, CA199, CA153 ）. Results：After the treatment, the degree of reduction in the amount of seroperitoneum was greater than 90% in 11 ca- ses ,greater than 50% in 28 cases. The total effective rate was 79.59%. 18.36% of the patients had side effects such as nausea and vomiting. The PS score and maximum diameter of seroperitoneum of the patients after treatment were improved significantly（ P 〈 0.01 ）. Tumor markers were significantly lower than before treatment（ P 〈 0.05 ）. Con- clusion：Intraperitoneal hyperthermal chemotherapy in the treatment of gynecological malignant seroperitoneum is ef- fective, safe and tolerable with slight side effects.