摘要
目的探讨在进展期结直肠癌术中使用洛铂腹腔化疗对术后肠功能恢复及术后并发症等安全性的影响。方法前瞻性纳入2013年10月至2014年10月间在四川医科大学附属第一医院胃肠外科接受手术治疗的103例结直肠癌患者，按病例分配随机表分为腹腔化疗组（55例）和对照组（48例）。腹腔化疗组术中采用洛铂40mg进行腹腔化疗，术后行FOLFOX方案（氟尿嘧啶、奥沙利铂和亚叶酸钙）静脉化疗；对照组单纯手术后予以FOLFOX方案静脉化疗。比较两组术后肠道功能恢复时间、并发症发生情况、化疗不良反应及手术后、静脉化疗后的血细胞和肝肾功能。结果腹腔化疗组和对照组肠功能恢复时间分别为（72．1±11．8）h和（68．7±13．4）h，差异无统计学意义（P〉0．05）；术后各有6例（10．9％和12．5％）出现切口脂肪液化（P〉0．05），均无全身感染及腹腔内感染发生。静脉化疗过程中，两组分别有42例（76．4％）和40例（83．3％）出现恶心呕吐，38例（69．1％）和29例（60．4％）出现便秘，4例（7.3％）和5例（10．4％）出现腹泻，差异均无统计学意义（均P〉0．05）；上述不良反应均经对症处理或在化疗结束后症状消失。两组患者无论是手术后还是化疗结束后，白细胞计数、血小板计数、丙氨酸转氨酶、天冬氨酸转氨酶及肌酐浓度等指标的差异均无统计学意义（均P〉0．05）。结论进展期结肠癌术中使用洛铂行腹腔化疗具有良好的耐受性和安全性。
Objective To observe the impact of intraoperative peritoneal chemotherapy with Lobaplatin on the safety of postoperative bowel function and complications in patients with advanced colorectal cancer. Methods A total of 103 colorectal cancer patients undergoing surgical operations in our department between October 2013 and October 2014 were prospectively enrolled in this study and were randomly divided into peritoneal chemotherapy group （55 cases） and control group （48 cases） according to the random table. In therapy group, patients were treated with peritoneal implantation of 40 mg Lobaplatin intraoperatively and followed by intravenous chemotherapy using FOLFOX regimen with Oxaliplatin, Fluorouracil and Leucovorin. In control group, only FOLFOX regimen was fulfilled. Then the recovery time of bowel function, the incidence of adverse reactions and complications, and the pre- and post-chemotherapy routine blood tests and hepatorenal functions were compared. Results The recovery time of bowel function in peritoneal chemotherapy group and control group was （72.1 ±11.8） h and （68.7±13.4） h respectively without significant difference （P〉0.05）. Each group had 6 cases with incisional fat liquefaction （10.9% vs. 12.5%, P〉0.05）. There was no serious infection in both groups.During intravenous chemotherapy, in peritoneal chemotherapy group and control group, the incidence of nausea and vomit （42 cases, 76.4% vs. 40 cases, 83.3%）, constipation （38 cases, 69.1% vs. 29 cases, 60.4%）, and diarrhea（4 cases, 7.3% vs. 5 cases, 10.4%） were observed and there were no significant differences（all P〉0.05）. It was noted that all these side effects vanished after chemotherapy or cured by symptomatic treatment. There were no significant differences between two groups in indexes of white blood cell, platelet, alanine aminotransferase, aspartate transaminase, and creatinine （all P〉0.05）, neither after operation nor after chemotherapy. Conclusion Peritoneal implantation of Lobaplatin as intraoperative chemotherapy for advanced colorectal cancer is safe and tolerable.
出处
《中华胃肠外科杂志》
CAS
CSCD
北大核心
2015年第10期1006-1010,共5页
Chinese Journal of Gastrointestinal Surgery
关键词
结直肠肿瘤
腹腔化疗
洛铂
不良反应
Coloreetal neoplasms
Intraperitoneal chemotherapy
Lobaplatin
Adverse reaction
