下肢骨肉瘤区域高温隔离灌注化疗并发症的预防  

The Prevention of Complications in Regional IsolatedPerfusion for Tumors of Lower Extremitieswith Hyperthermic Chemotherapy

作　　者：徐世伟[1] 陈芳[1] 赵玉华[1] 

机构地区：[1]浙江医科大学附属第二医院心胸外科,杭州市310009

出　　处：《中国肿瘤临床》1996年第11期793-795,共3页Chinese Journal of Clinical Oncology

摘　　要：1990年8月~1995年7月共50例下肢骨肉瘤区域高温隔离灌注化疗病人,男31例,女19例,年龄平均21岁。肿瘤部位:股骨下端32例,胫骨16例,腓骨2例。病人先作活检病理,确诊后作全身化疗1次,2周后作区域高温隔离灌注化疗,11例用顺铂(150mg/m^2),39例用卡铂(600mg/m^2)。化疗60min,肿瘤缘深部组织温度保持在42℃。结果:引起严重并发症4例,其中3例骨筋膜综合征(6%),1例急性肾衰(2%)。作者对并发症的病因作了探讨,并提出要减少和预防严重并发症应注意:1)转中流量不宜超过1000ml/min,且静脉引流量应与供血量相等;2)肢体温度应控制在42℃;3)灌注化疗不宜超过60min;4)组织灌洗要充分;5)注意结扎沟通全身循环的血管分支。From August 1990 to June 1995,50 patients with osteosarcoma of lower extremities were treated with chemotherapy by way of hyperthermic regional isolated perfusion. There were 31 males and 19 females with a mean age of 21 (13-30) years. All of the tumors were located in the lower limbs, 32 in the femur, 16 the tibia and 2 the fibula. Isolated perfusion was done lasting for 60 minutes with 42℃ of heat in the depth of soft tissues around the tumor. Serious complications occurred in 4 cases,3 compression syndrome, and 1 renal failure. The authors enumerate preventive measures against complications: (l)the perfusion volume of fluid shouldn't exceed 1000 ml/min, (2) the temperature of the perfused extremity should be kept at 42℃ > (3) perfusion time must not be in excess of 60 minutes, (4) sufficient irrigation after the perfusion,and (5) ligate the branches of the perfused blood vessels to assure isolation.

关 键 词：骨肉瘤 药物疗法 并发症 预防 

分 类 号：R738.1[医药卫生—肿瘤]