摘要
目的探讨腹腔镜辅助持续循环腹腔热灌注化疗（laparoscopic—assisted continuous circulatary hyperthermic perfusion intraperitoneal chemotherapy，LAHPIC）治疗恶性腹水的方法、可行性及临床初步疗效。方法对我院2006年3月-2008年3月收治的21例恶性腹水患者应用LAHPIC，每例3次，首次治疗在手术室内完成，随后2次在ICU进行，灌注速度450～600ml／min，灌注时间90min，治疗温度（43±0．2）℃，化疗药物根据原发病的不同选择5-氟尿嘧啶加丝裂霉素或卡铂，并对其治疗效果进行长期随访。结果21例患者手术均进行顺利，平均手术时间80min，无与LAHPIC技术相关的并发症发生。19例患者腹水全部消失，2例部分缓解，有效率为100％。患者KPS评分上升（P〈0．01），肿瘤标志物下降，一般状况好转，近期临床疗效满意。结论LAHPIC可保证腹腔内灌注液体均匀分布，维持腹腔内温度稳定，维持化疗药物与肿瘤的充分接触，具有创伤小、患者痛苦少、术后恢复快、疗效肯定等优点，有着很好的临床应用前景。
Objective To investigate the measurement, feasibility and clinic effect of laparoscopic-assisted continuous circalatary hyperthermic perfusion intraperitoneal chemotherapy （LAHPIC） in the treatment of malignant ascites from peritoneal carcinomatosis. Methods From March 2006 to March 2008 LAHPIC approach was performed on 21 patients affected by malignant ascites secondary to peritoneal carcinomatosis. Every patient was performed LAHPIC for three times, the first time were completed in operative room by general anesthesia, the second and third were performed in intensive care unit （ICU）, solution was delivered continuous circulatary perfusion inflow peritoneal cavity by 450 - 600ml/min in every LAHPIC, and intraperitoneal perfusion of mitomycin-C and cisplatin was delivered for 90min with an inflow temperature of 43 degrees C. And these patients were performed long-term followed up LAHPIC later. Results LAHPIC course was uneventful in all cases, and mean operative time was 80min. Clinical complete regression of ascites was achieved in 19 patients treated, and partial remission achieved in 2 patients. No postoperative deaths and complication related to the procedure occurred in this study. The patients KPS grades rised （P〈0.01）, the tumor marker decreased, and the patient general status improvement, satisfy clinic effectiveness had been acquired in these patients treated by laparoscopic LAHPIC. Conclusion LAHPIC appears to be a safe, feasibility and effective procedure to treat debilitating malignant ascites from unresectable peritoneal carcinomatosis, which has less trauma and pain in patients with quick postoperative recovery,would have a clinic good perspective in future.
出处
《国际医药卫生导报》
2009年第16期42-45,共4页
International Medicine and Health Guidance News
关键词
腹腔镜
腹腔
热灌注
化疗
恶性肿瘤
腹水
Laparoscopy
Intraperitoneal
Hyperthermic perfusion
Chemotherapy
Malignant tumor
Malignant ascites
