腹膜淋巴结转移癌诱发的肠梗阻应用肠系膜上动脉灌注化疗的临床观察

Superior mesenteric artery perfusion chemotherapy for treatment of intestinal obstruction caused by peritoneal lymph node metastasis

目的研究腹膜淋巴结转移癌诱发的肠梗阻应用肠系膜上动脉(superior mesenteric artery,SMA)灌注化疗的临床疗效.方法本文选取天津市第四中心医院2013-01-01/2016-12-01收治的腹膜淋巴结转移癌诱发肠梗阻患者94例进行研究,采用随机数表法将患者分为观察组和对照组各47例,对照组患者给予肠梗阻常规治疗,观察组患者给予SMA灌注化疗,比较两组患者治疗后临床疗效,临床症状缓解时间、不良反应发生率以及生存时间.结果观察组患者治疗后总有效率明显高于对照组(91.49%v s 76.60%),组间比较差异有统计学意义(P<0.05);观察组患者恢复排气时间(4.54 d±1.26 d vs 8.27 d±2.39 d)、恢复排便时间(2.67 d±0.61 d vs5.24 d±1.05 d)以及腹胀、腹痛缓解时间(4.61 d±1.26 d vs 8.27 d±2.35 d)均明显短于对照组,观察组患者肠道通畅维持时间明显长于对照组(111.25 d±32.58 d vs 28.35 d±6.41 d),组间比较差异有统计学意义(P<0.05);观察组患者不良反应发生率明显低于对照组(8.51%vs 23.40%),两组对比差异有统计学意义(P<0.05);观察组患者治疗后生存时间为明显长于对照组(5.28 mo±1.16 mo vs 2.15 mo±0.86 mo),对比差异有统计学意义(P<0.05).结论腹膜淋巴结转移癌诱发的肠梗阻应用SMA灌注化疗临床疗效显著,可降低不良反应的发生率,改善患者临床症状恢复时间,促进患者的恢复,值得临床推广应用.

AIM To observe the clinical effects of superior mesenteric artery（SMA） perfusion chemotherapy in management of peritoneal obstruction caused by lymph node metastasis.METHODS Ninety-four patients with intestinal obstruction caused by peritoneal lymph node metastasis treated at our hospital from January 1, 2013 to December 1, 2016 were randomly divided into either a control group or an observation group, with 47 cases in each group. The control group was given routine treatment for intestinal obstruction, while the observation group was given SMA perfusion chemotherapy. Clinical efficacy, time to clinical symptom remission, adverse reaction rate, and survival time were compared between the two groups. RESULTS The total effective rate of the observation group was significantly higher than that of the control group（91.49% vs 76.60%, P〈0.05）. The times to anal exhaust, defecation, and relief of abdominal distension and abdominal pain were significantly shorter in the observation group than in the control group（4.54 d ± 1.26 d vs 8.27 d ± 2.39 d, 2.67 d ± 0.61 d vs 5.24 d ± 1.05 d, 4.61 d ± 1.26 d vs 8.27 d ± 2.35 d, P〈0.05）, while the duration of relief of intestinal obstruction was significantly longer in the observation group（111.25 d ± 32.58 d vs 28.35 d ± 6.41 d, P〈0.05）. The incidence of adverse reactions in the observation group was significantly lower than that in the control group（8.51% vs 23.40%, P〈0.05）, but the survival time of the observation group after treatment was significantly longer than that of the control group（5.28 mo ±1.16 mo vs 2.15 mo ± 0.86 mo, P〈0.05）. CONCLUSION SMA perfusion chemotherapy can effectively reduce the incidence of adverse reactions, improve clinical symptoms, and promote the recovery of patients in the management of intestinal obstruction caused by peritoneal lymph node metastasis.