进展期胃癌术中实施区域性缓释化疗的安全性和远期疗效

Long-term efficacy and safety of regional sustained release chemotherapy on advanced gastric cancer during operation

目的探讨进展期胃癌术中实施区域性缓释化疗的安全性和远期疗效,为临床治疗提供参考依据。方法将160例胃癌患者随机分为观察组与对照组各80例,均行胃癌根治术,对照组给予常规处理,观察组于术中给予氟尿嘧啶缓释剂,比较两组患者不良反应、生存率和免疫功能水平。结果两组患者术后不良反应以及肠功能恢复时间、平均住院时间比较差异无统计学意义(P>0.05);术后两组患者AST、ALT、白细胞水平均高于术前,Cr水平低于术前,差异均有统计学意义(均P<0.05);而两组间比较,差异无统计学意义(均P>0.05);观察组CD3+水平低于术前及对照组,差异有统计学意义(P<0.05);观察组第2、3年和3年间复发率及死亡率均低于对照组,差异均有统计学意义(均P<0.05)。结论进展期胃癌患者术中给予氟尿嘧啶缓释剂具有较好的耐受性和安全性,对患者肝肾功能影响轻微,降低了远期复发率和死亡率,对免疫功能可能存在抑制作用。

Objective To investigate safety and long term effect of regional sustained release chemotherapy on advanced gastric cancer during operation.Methods 160 gastric cancer patients were randomly divided into observation group and control group with 80 cases in each group.Underwent radical resection of gastric cancer,the control group was given conventional treatment,but the observation group was given fluorouracil sustained release.The adverse reactions,survival rate and immune function were observed.Results The postoperative adverse reaction,intestinal function recovery time and hospitalization time had no significant difference（P〈0.05）.AST,ALT and white blood cell after operation were higher than those before operation.Cr after operation was lower than that before operation（P〈0.05）.ALT,white blood cell and Cr of the two groups were not significant different（P〈0.05）.CD3＋of observation group was lower than that of the control group（P〈0.05）.The second years,third years and three years recurrence rate and mortality of observation group were lower than that of the control group（P〈0.05）.Conclusion Regional sustained release chemotherapy is safe and tolerant for patients with gastric cancer,which can reduce the recurrence rate and mortality and inhibit the immune function.