摘要
目的:探讨腹腔热灌注化疗(hyperthermic intraperitoneal chemotherapy,HIPEC)治疗胃癌恶性腹水的临床疗效.方法:按照随机数字表法将70例患者均分为实验组和对照组,每组35例,实验组患者给予HIPEC联合热疗治疗,对照组患者给予常温腹腔灌注化疗,比较两组患者临床疗效、治疗前后Kamofsky评分变化情况以及不良反应发生情况,记录实验组患者HIPEC治疗过程中不同时间点温度和生命体征变化情况.结果:实验组患者总有效率显著高于对照组(77.14%vs 37.14%),差异具有统计学意义(P<0.05);两组患者治疗后Kamofsky评分均显著升高,与治疗前比较(77.92分±6.83分vs 54.44分±5.47分,62.08分±6.17分vs 53.89分±5.56分),差异具有统计学意义(P<0.05);实验组治疗后Kamofsky评分显著高于对照组(77.92分±6.83分vs 62.08分±6.17分),差异具有统计学意义(P<0.05);实验组患者HIPEC治疗过程中各时间点体表温度、鼓膜温度、直肠温度、血压、心率、呼吸、血氧饱和度等均在正常范围内,无明显变化(36.18℃±0.42℃vs 36.42℃±0.27℃vs 37.13℃±1.72℃,35.66℃±0.23℃vs 35.94℃±0.37℃vs 36.60℃±0.22℃,36.34℃±0.12℃vs 36.64℃±0.27℃vs 37.10℃±0.30℃,117 mmHg±6.2 mmHg vs 116 mmHg±6.5 mmHg vs 116 mmHg±6.4 mmHg,62 mmHg±4.9 mmHg vs 69 mmHg±6.8 mmHg vs 72 mmHg±5.3 mmHg,68次/min±4.3次/min vs 72次/min±5.3次/min vs 73次/min±4.5次/min,14次/min±2.5次/min vs 13次/min±1.8次/min vs 14次/min±1.7次/min,98%±1.8%vs 97%±0.9%vs 98%±1.3%),差异无统计学意义(P>0.05);实验组患者脂肪硬结发生率显著高于对照组(14.29%vs 0.00%),差异具有统计学意义(P<0.05).结论:HIPEC可显著改善患者Kamofsky活动状态评分,安全性高,不明显增加不良反应,疗效显著,是治疗胃癌恶性腹水的优选方案.
AIM: To assess the clinical effects of hyperthermic intraperitoneal chemotherapy(HIPEC) in the treatment of gastric cancer with malignantascites.METHODS: Seventy patients with gastric cancer with malignant ascites were randomly divided into either a study group or a control group. The study group was treated by HIPEC combined with thermal therapy, and the control group was treated by non-hyperthermic peritoneal perfusion chemotherapy. The clinical effects, Kamofsky score and adverse reactions were compared for the two groups. The temperature and vital signs at different points of HIPEC were recorded.RESULTS: The total effective rate was significantly higher in the experiment group than in the control group(77.14% vs 37.14%, P 0.05). Posttreatment Kamofsky scores for the two groups were significantly higher than prior-treatment values(77.92 ± 6.83 vs 54.44 ± 5.47, 62.08 ± 6.17 vs 53.89 ± 5.56, P 0.05). Posttreatment Kamofsky score was significantly higher in the experiment group than in the control group(77.92 ± 6.83 vs 62.08 ± 6.17, P〈0.05). There were no significant difference in the shell temperature, tympanic temperature, rectal temperature, blood pressure, heart rate, breath, or oxyhemoglobin saturation for the experiment group at different time points(36.18 ℃ ± 0.42 ℃ vs 36.42 ℃ ± 0.27 ℃ vs 37.13 ℃ ± 1.72 ℃, 35.66 ℃ ± 0.23 ℃ vs 35.94 ℃ ± 0.37 ℃ vs 36.60 ℃ ± 0.22 ℃, 36.34 ℃ ± 0.12 ℃ vs 36.64 ℃ ± 0.27 ℃ vs 37.10 ℃ ± 0.30 ℃, 117 mmHg ± 6.2 mmHg vs 116 mmHg ± 6.5 mmHg vs 116 mmHg ± 6.4 mmHg, 62 mmHg ± 4.9 mmHg vs 69 mmHg ± 6.8 mmHg vs 72 mmHg ± 5.3 mmHg, 68/min ± 4.3/min vs 72/min ± 5.3/min vs 73/min ± 4.5/min, 14/min ± 2.5/min vs 13/min ± 1.8/min vs 14/min ± 1.7/min, 98% ± 1.8% vs 97% ± 0.9% vs 98% ± 1.3%, P〉0.05). The rate of fatty scleroma for the experiment group was significantly higher than that for the control group(14.29% vs 0.00%, P 0.05).CONCLUSION: HIPEC can improve Kamofsky score and has high safety in patients with gastric cancer with malignant ascites.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第31期4825-4829,共5页
World Chinese Journal of Digestology
关键词
腹腔热灌注化疗
胃癌
恶性腹水
疗效
Hyperthermic intraperitoneal chemotherapy
Gastric cancer
Malignant ascites
Clinical effects