腹水浓缩回输联合腔内免疫化疗治疗恶性腹水疗效观察  

The study of ultrafiltration and reinfusion of ascites combined with intraperitoneal chemotherapy to treat the ascites caused by malignant tumor

作　　者：胥莹[1] 秦继勇[2] 焦健[1] 刘桂兰[1] 杨黎宏[1] 程宇[1] 杨晋辉[1] 

机构地区：[1]昆明医学院第二附属医院肝胆胰内科,云南昆明650101 [2]昆明医学院第三附属医院放疗科,云南昆明650118

出　　处：《云南医药》2011年第1期20-22,共3页Medicine and Pharmacy of Yunnan

摘　　要：目的评价腹水浓缩回输联合腔内免疫化疗治疗恶性腹水的临床疗效。方法选择晚期腹盆腔肿瘤并恶性腹水患者186例,随机分为3组,采用腹水超滤浓缩自体腹腔回输联合腹腔内化疗和生物调节治疗(免疫化疗)为A组,采用腹水超滤浓缩自体腹腔回输联合腹腔内化疗为B组,治疗性放腹水联合腔内化疗为C组。经B超或CT生化检查检查判断腹水改善情况,评价疗效和副反应。结果疗程结束时A组近期临床有效率(RR)82.5%,疾病控制率(DCR)88.9%。B组(RR)50.8%,(DCR)70.5%。C组(RR)33.9%,(DCR)56.4%。腹水自体回输可增加血清蛋白的含量,提高胶体渗透压,联合腔内免疫化疗能有效控制腹水,改善一般状况,且无明显毒副反应。结论腹水浓缩回输联合腔内免疫化疗对恶性腹水近期控制有一定疗效,安全可靠,简便易接受的特点,可提高患者的生存质量,是治疗恶性腹水的有效手段。Objective To study the effects of uhrafiltration and reinfusion of ascites combined with intraperitoneal chemotherapy to treat the ascites caused by malignant tumor. Methods 186 patients with ascites caused by malignant tumor which located in the abdominal and pelvic cavity were randomly divided into three groups： patients in group A were treated by uhrafihration and concentration of ascites combined with intraperitoneal chemotherapy and immuno-chemotherapy, patients in group B were treated by ultrafiltration and concentration of ascites and autoinfusion combined with intraperitoneal chemotherapy, patients in C group were treated by intraperitoneal paracentesis and intrapcritoneal chemotherapy. B-US, CT and biochemical detection were carried out to detect the changes of ascites and curative effects. Results At the end of treatment, in group A the clinical effect rate RR was 82.5%.the disease control rate DCR was 88.9%; in group B, RR was 50.8%. DCR was 70.5%. In group C, RR was 33.9%, DCR was 56.4%. We found that ultrafihration and reinfusion of ascites might increase the content of albumin in serum, raise the colloid osmotic pressure and decrease the production of ascites. Conclusion Uhrafihration and reinfusion of ascites combined with intraperitoneal chemotherapy and immuno-chemotherapy are an effective and safe therapy to treat the patients with ascites caused by malignant tumor.

关 键 词：恶性腹水 免疫化疗 腹水浓缩自体腹腔回输 

分 类 号：R442.5[医药卫生—诊断学]