改良体外循环体腔热灌注技术在肿瘤化疗中的应用

Application of modified cardiopulmonary bypass body cavity hyperthermic perfusion technique in tumor chemotherapy

目的探讨改良体外循环体腔热灌注技术在肿瘤化疗中的应用效果。方法选取2015年1月至2022年3月在首都医科大学附属北京安贞医院进行热灌注化疗的患者21例,其中行改良体外循环单侧胸腔热灌注化疗(E-HITEC)12例(E-HITEC组),行改良体外循环腹腔热灌注化疗(E-HIPEC)9例(E-HIPEC组)。比较2组患者术中生命体征,以及灌注流速、预充液体总量和体腔温度变化。术后观察患者有无胸腔积液或腹腔积液复发,并记录院内结局。结果E-HIPEC组灌注流速、预充液体总量、出入体腔温差均大于E-HITEC组[(2585±308)ml/min比(1910±381)ml/min、3000(3000,3100)ml比2400(2125,2500)ml、(0.8±0.3)℃比(0.4±0.1)℃](均P<0.05)。除1例患者接受E-HITEC后仍有胸腔积液生成外,其余患者住院期间均未出现胸腔积液或腹腔积液复发现象。住院期间患者死亡2例,其余19例患者均病情好转,存活出院。结论改良体外循环体腔内热灌注化疗可结合手术或单独使用,能快速达到目标温度,对患者生命体征影响小,可有效延缓胸腔积液或腹腔积液的生成,有助于胸膜或腹膜原发或肿瘤转移患者的治疗。

Objective To investigate the application effect of modified cardiopulmonary bypass body cavity hyperthermic perfusion technique in tumor chemotherapy.Methods From January 2015 to March 2022,21 patients who underwent hyperthermic perfusion chemotherapy in Beijing Anzhen Hospital,Capital Medical University were selected.Among them,12 patients underwent modified cardiopulmonary bypass unilateral intrathoracic hyperthermic perfusion chemotherapy(E-HITEC group),and 9 patients underwent modified cardiopulmonary bypass intraperitoneal hyperthermic perfusion chemotherapy(E-HIPEC group).The vital signs,perfusion flow rate,total volume of pre-filled fluid and changes in body temperature were compared between the two groups.Results The perfusion flow rate,total volume of pre-filled fluid and temperature difference in and out of body cavity in E-HIPEC group were higher than those in E-HITEC group[(2585±308)ml/min vs(1910±381)ml/min,3000(3000,3100)ml vs 2400(2125,2500)ml,(0.8±0.3)℃vs(0.4±0.1)℃](all P<0.05).Except for 1 patient who still had pleural effusion after receiving E-HITEC,the other patients did not have recurrence of pleural effusion or peritoneal effusion during hospitalization.During hospitalization,2 patients died,and the other 19 patients recovered and were discharged alive.Conclusions Modified cardiopulmonary bypass intracavitary hyperthermic perfusion chemotherapy can be used in combination with surgery or alone,which can quickly reach the target temperature and has little effect on the vital signs of patients.It can effectively delay the generation of pleural effusion or peritoneal effusion,and is helpful for the treatment of patients with primary pleural or peritoneal effusion or tumor metastasis.