消化道恶性肿瘤患者术中腹腔内植入5-FU缓释剂的安全性研究  

Safety Evaluation of Intra-Abdominal Implantation of Sustained-Releasing 5-Fluorouracil in Gastrointestinal Malignant Tumor

作　　者：刘流[1] 庄文[1] 陈忠[2] 陈博[1] 

机构地区：[1]四川大学华西医院胃肠外科,成都610041 [2]四川大学华西第二医院儿科,成都610041

出　　处：《中国普外基础与临床杂志》2010年第2期170-174,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨胃癌和结直肠癌患者根治性术中植入5-氟尿嘧啶(5-FU)缓释剂对术后肝肾功能、免疫功能、营养状态及并发症发生率的影响。方法选取2009年1～6月期间确诊为胃癌或结直肠癌并行根治术的患者65例(胃癌35例,结肠癌18例,直肠癌12例),随机分为试验组(n=25)和对照组(n=40)。试验组术中腹腔内植入5-FU缓释剂400mg。术前及术后第2天、第7天分别检测肝肾功能、免疫功能及营养状态并记录术后并发症发生率、术后肛门排气时间及术后住院时间。结果2组患者在性别、肿瘤TNM分期、术前肝肾功能、营养及免疫指标方面的差异均无统计学意义(P>0.05)。术后第2天试验组的总蛋白水平和转铁蛋白水平明显低于对照组,而血尿素氮水平及IgM水平明显高于对照组,差异均有统计学意义(P<0.05);术后第7天试验组淋巴细胞计数明显高于对照组(P<0.05),而总蛋白水平、Alb、CD4水平及IgA水平明显低于对照组,差异亦有统计学意义(P<0.05)。试验组术后肛门排气时间明显长于对照组(P<0.05)。结论术中植入5-FU缓释剂治疗胃癌及结直肠癌是安全可行的,不增加术后并发症和术后住院时间,但是对患者免疫功能有一定抑制作用并影响肠道功能的恢复。Objective To explore the postoperative influence of intra-abdominal implantation of sustained-releasing 5-fluorouracil on the hepato-renal function,immune function,nutritional state and complications in patients with gastric and colorectal cancer. Methods Sixty-five patients with gastric or colorectal cancer were included into this study from January to June 2009. The patients （35 cases of gastric cancer,18 cases of colon cancer and 12 cases of rectal cancer） were randomly divided into experimental group （n=25） and control group （n=40）. In experimental group,400 mg sustained-releasing 5-fluorouracil was used. Blood samples were gained before operation,the second day and the seventh day after operation to examine the indexes of hepato-renal function,immune function and nutritional state. Complications,venting time and length of stay after operation were also recorded. Results There was no statistical significance for distribution of tumor stages and patients＇ gender between experimental group and control group （P0.05）. Preoperative indexes of hepato-renal function,immune function and nutritional state were also not reached statistical significance between two groups （P0.05）. Compared with control group,the indexes of total protein and transferrin were decreased and urea nitrogen and IgM were increased in the second day after operation in experimental group （P0.05）. The number of lymphocyte was increased,while CD4,Alb,total protein and IgA were decreased in the seventh day after operation in experimental group,respectively. The time of passage of gas of experimental group was longer than that of control group （P0.05）. Conclusion Intra-abdominal implantation of sustained-releasing 5-fluorouracil is safe and feasible,which does not increase the complications and the time of length stay after operation. However,there is a little influence on immune function and gastrointestinal function after operation for intra-abdominal implantation of sustained-releasing 5-fluorouracil.

关 键 词：胃癌 结直肠癌 5-氟尿嘧啶缓释剂 安全性 并发症 

分 类 号：R735[医药卫生—肿瘤]