结直肠癌术后顺铂和5-氟尿嘧啶化疗及枢复宁对胃肠动力的影响  

Effects of cisplatine, 5-FU and ondansetron on gastrointestinal motility of the colorectal cancer patients after radical operation.

作　　者：秦新裕[1] 宋陆军[1] 吴肇光[1] 

机构地区：[1]上海医科大学中山医院外科,上海200032

出　　处：《中国胃肠外科杂志》1998年第1期30-32,共3页

摘　　要：14例结直肠癌术后化疗病人进行胃肠动力采用 PC Polygraf HR 台式高分辨八导消化道动力监测系统进行测压;第一天为对照期,第二天为化疗期,方案为顺铂40mg 和5-FU 500mg;第三天为枢复宁期,继续化疗药物,化疗前5min 静推枢复宁8mg。结果显示对照期 MMC 个数为9.14±2.54个/人,化疗期增至13.14±3.96个/人(P<0.01)。枢复宁期MMC 数为13.07±3.60个/人。MMC 周期对照期为170±50min,化疗期期缩短至122±47min(P<0.05)。枢复宁期为124±65min。MMC 移行速度对照期为0.114±0.028cm/sec,化疗期加快至0.161±0.049cm/sec,枢复宁期 MMC 的移行速度平均为0.13±0.017cm/sec。MMCⅢ相收缩波数对照期为453±109个/人。化疗期增加至664±196个/人(P<0.01)。枢复宁期 MMCⅢ相收缩波数为646±209个/人。MMCⅢ相收缩波幅植对照期为4.09±0.99kPa,化疗期为4.13±1.13kPa(P<0.05)。枢复宁期为3.92±1.19kPa。应用化疗药物后14例病人中9例发生呕吐,发生呕吐的时间为280±28min。应用枢复宁后,无病人再发生呕吐(P<0.05),但不增强胃肠道平滑肌的收缩强度。枢复宁可抑制化疗药物引起的呕吐,化疗药物引起胃肠动力加快和呕吐属于两不同的机制,两者间无因果关系。Objectives 14 colorectal cancer patients were measured their gastrointestinal motility for 3 days after a radical operation by using a PC Polygraf HR GI motility measuring system.The first day was the control period without any drugs.The second day was the chemotherapy period and the patients were administrated cisplatine(40rag)and 5-FU(500mg).The third day was the chemotherapy plus ondansetron period and the patients were not only given cisplatine and 5-FU,but also given ondansetron(8mg)5 minutes before the above drugs.The results showed that the number of MMC was increased from 9.14±2.25/patitent in the control period to 13.14±3.96 in the chemotherapy period(P<0.001).It was not significantly changed after the administration of ondansetron(13.07±3.60).The cycling duration of MMC was 170± 50min in the control period and it was decreased to 122±47min in the chemotherapy period(P<0.05). There was no change after the ondansetron(124±65min).Propagating velocity of MMC was increased from 0.114±0.028cm/sec in the control period to 0.161±0.049cm/sec in the chemotherapy period and the ondansetron period is 0.131±0.017cm/sec which is not significantly different from the chemotherapy period. Phase Ⅲ contractions was 463±109 in the control period and it was incrased to 664±196 in the chemotherapy period(P<0.01).There was no signifeicant change after ondansetron(646±209).The amplitudes of phase Ⅲ 4.09±0.99kPa in the control period,4.13±1.13kPa in the chemotherapy period and 3.92±1.19kPa in the ondansetron period,respectively.There was no significant difference during those periods(P<0.05). Emesis occurred in 9 of total 14 patients.The average period between the administration of chemotherapy and emesis was 280±25min.After the administration of ondansetron there was no emesis occurred in those patients (P<0.05).In conclusion,we believe that the increased GI motility and emesis by cisplatine and 5-FU are via different pathway.

关 键 词：结直肠癌 顺铂 5-氟尿嘧啶 化疗 枢复宁 胃肠动力 胃肠测压 

分 类 号：R735.3[医药卫生—肿瘤]