妇科恶性肿瘤淋巴结转移的腹膜后与腹腔化学治疗的比较  

The Contrast between Chemotherapy via Pelvic Retroperitoneal Cannulation and Intraperitoneal Chemotherapy in Gynecological Malignancies Cancers with Lymph Node Metastases

作　　者：曹泽毅[1] 张丹[1] 彭芝兰[1] 周世英 黎培毅 杨延林[1] 张崇淑 尤宗兵 

机构地区：[1]华西医科大学第二附属医院妇产科,成都640041

出　　处：《中华妇产科杂志》1999年第9期540-543,I013,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的　比较妇科恶性肿瘤患者淋巴结转移的腹膜后化学治疗（ 化疗） 和腹腔化疗的疗效，并进一步评价腹膜后化疗。方法　选择６２ 例妇科恶性肿瘤患者，手术前分别随机进行腹膜后化疗４３ 例、腹腔化疗重复给药１１ 例和腹腔化疗单次注药（５ 氟尿嘧啶，５ Ｆ Ｕ）８ 例，采用高效液相色谱测定法（ Ｈ Ｐ Ｌ Ｃ） 检测淋巴结内５ Ｆ Ｕ 的浓度。其中１６ 例腹膜后化疗重复给药患者，比较注药侧与未注药侧淋巴结内５ Ｆ Ｕ 的浓度。选择腹膜后化疗患者６ 例，分别经盆腔腹膜外间隙注入锝硫化锑和伊索显３００ 各３ 例，分别采用单光子发射计算机体层摄影术和 Ｘ 线摄片，观察药物分布的范围。结果　（１） 腹主动脉旁淋巴结５ Ｆ Ｕ 浓度，腹膜后化疗是腹腔化疗的７６ ～１１９ 倍；盆腔淋巴结５ Ｆ Ｕ 的浓度，腹膜后化疗是腹腔化疗的６６ ～１０６ 倍；（２） 腹膜后化疗重复注药，注药侧５ Ｆ Ｕ 浓度为未注药侧的１６ ～２０倍；（３） 腹膜后化疗与腹腔化疗均无明显的毒副作用；（４） 经盆腔腹膜外间隙给药，药物能从盆腔上行至腹主动脉旁淋巴结及其周围。结论　对于有淋巴转移的妇科恶性肿瘤的治疗，采用腹膜后途径重复给药化疗的疗效，明显优于腹腔化疗。Objective To contrast the pelvic retroperitoneal (RP) chemotherapy with intraperitoneal (IP) chemotherapy in gynecological malignancies with lymph node metastases. Methods Fluorouracil (5 FU) was repeatedly injected into the pelvic retroperitoneal space of 43 patients and the abdominal cavity of 11 patients High performance liquid chromatography was used to determine the drug concentration of 5 FU 5 FU was repeatedly injected into the pelvic retroperitoneal space of 16 patients via cannulation to observe the nodal 5 FU concentration of injected side and the control side 99m Tc Sb 2S 3, Isovist 300 were injected into the pelvic retroperitoneal space of two groups (each one has 3 patients) respectively via cannulation Single proton emission computer tomography (SPECT) and X Ray film were taken to observe the allocation of the drugs Results (1) Pelvic and periaortic nodal 5 FU concentrations of RP were 60～106 and 76～119 times of that of IP respectively (2) The nodal 5 FU concentrations on repeated injection side were 16～20 times of that on control sides of RP (3) There was no complications or adverse effect observed (4) 5 FU was allocated to the space including the external iliac, internal iliac, obturator, deep inguinal and common iliac lymph nodes and also up to the periaortic lymph nodes Conclusion RP was more effective than IP for the treatment of lymphatic metastasis of gynecologic cancer

关 键 词：妇科肿瘤 药物疗法 淋巴结转移 氟尿啶啶 

分 类 号：R737.305[医药卫生—肿瘤] R73－37[医药卫生—临床医学]