术前静脉术中腹腔化疗对胃癌手术影响的观察

Influence of Preoperative Intravenous and Intraoperative Intraperitoneal Chemotherapy on The Operation for Advanced Gastric Carcinoma

目的 观察术前静脉化疗和术中腹腔化疗是否会延误手术时机 ,增加手术危险和术后并发症以及对术后恢复的影响。方法 对入院的进展期胃癌患者 ,在控制对观察结果影响较大因素的条件下 ,按入院顺序分为观察及对照两组比较。观察组术前静脉、术中腹腔用MMC、5 -Fu、CF(甲酰四氢叶酸钙 )化疗。对照组术前、术中不给化疗。记录术前住院日 ,术中失血、输血量和术后恢复情况 ,观察化疗的毒副作用。结果 观察组术前化疗后 2 4例出现毒副反应。术前住院日 ,术中失血、输血量 ,术后并发症和恢复情况 ,两组间无显著差异。结论 选用适当药物、剂量和疗程 ,术前静脉和术中腹腔化疗不延误手术时机 ,是安全可行的 ,但需严密监测化疗药物的毒副作用 ,采取相应的防治措施。

Objective To observe whether preoperative intravenous(IV)and intraoperative intraperitoneal(IP)chemotherapy delays operative timing, increases operative risk and postoperative complications and interferes with postoperative recovery.Methods patients were divided into two groups allording to admission order from August 1997 to October 1999 on the premise of matching some factors obviously interfering with observation results. In observation group MMC?5\|Fu?CF were infused intravenously before operation. In control group the chemotherapy was applied neither preoperatively nor intraoperatively.Preoperative hospitalization, the volume of loss and transfusion blood in operation, the process of postoperative recover were recorded and the toxicity and side effects of chemotherapy drugs were observed and noted.Results 24 patients in observation group had toxicity and side effects following the preoperative chemotherapy.Preoperative hospitalization, the volume of lost and transfused blood in operation, postoperative complications, mortality and recover process were not significant differetial between two groups.Conclusion Preoperative IV and intraoperative IP chemotherapy is safe and feasible providing the drugs and their doses course of treatment are suitable. However, it is necessary to monitor the toxicity and side effects of anticaner drugs, and measures to provent and treat them should be adopted.\;