胃窦癌术中区域动脉灌注化疗后门静脉血、周围静脉血、腹腔渗液及癌组织中药物浓度的测定  

5-Fu concentration in splanchnic and peripheral blood, peritoneal fluid and carcinoma tissues after intraoperative regional arterial perfusion chemotherapy in patients of gastric antrum cancer

作　　者：夏术森[1] 王崇树[1] 张才全[2] 杜江[1] 魏寿江[1] 肖江卫[1] 张广军[1] 

机构地区：[1]川北医学院附属医院胃肠外科,四川省南充637000 [2]重庆医科大学附属第一医院胃肠外科

出　　处：《中华普通外科杂志》2013年第10期748-750,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨胃窦癌术中区域动脉灌注化疗的作用.方法 本组32例胃窦癌患者术中经胃网膜右动脉灌注5-氟尿嘧啶（5-Fu,1000 mg/m2）,用高效液相色谱法测定注药后2、5、10、20、30、60 min门静脉血、周围静脉血、腹腔渗液及切除癌组织中5-Fu的浓度.结果 于注药后2 min门静脉血及腹腔渗液即出现峰浓度,分别为（48.8±6.8）μg/ml及（75.3±30.7）μg/ml,于注药后30 min门静脉血的浓度为（19.2±2.0）μg/ml,于注药后60 min腹腔渗液的浓度为（17.3±7.4） μg/ml,均超过有效抑癌浓度（15 μg/ml）；于注药后5 min周围静脉血出现峰浓度,为（5.4±2.0） μg/ml,此后逐渐降低；手术切下的癌组织的药物浓度为（80.5±20.1）Lg/ml.结论 胃窦癌术中区域动脉灌注化疗可以在短时间内使门静脉血及腹腔渗液达到较高的药物浓度且持续时间长,术后切下的癌组织药物浓度远较周围血为高,有利于预防术中癌细胞的扩散及术后癌复发.Objective To measure 5Fu concentration after intraoperative regional arterial perfusion chemotherapy in gastric antrum cancer patients.Method In this study,32 gastric antrum cancer patients intraoperatively received through right gastroepiploic artery intraarterial perfusion of 5-Fu （1000 mg/m2）,and drug conentrations were measured in portal venous blood,peripheral venous blood,peritoneal fluid and in removed cancer tissues 2,5,10,20,30,60 minutes after infusion started by high performance liquid chromatography method.Result 5-Fu in portal vein blood and peritoneal fluid reached peak concentration after 2 minutes at （48.8 ±6.8） μg1/ml and （75.3 ±30.7） μg/ml,respectively.The drug concentration in portal venous blood was （19.2 ± 2.0） μg/ml at 30 minutes and that in peritoneal fluid was （17.3 ±7.4） μg/ml at 60 minutes,both were higher than that of the effective experimental tumor suppressing concentration （15 μg/ml）.Peripheral venous blood concentration reached peak concentration of （5.4 ± 2.0） μg/ml at 5 minute.The drug concentration in removed cancer tissues was （80.5 ± 20.1） μg,/ml.Conclusions Regional intraarterial perfusion chemotherapeutics in gastric antrum cancer patients during operation immediately makes the concentration of chemotherapy rise in the portal vein blood and peritoneal fluid and in cancer tissues to a much higher level than that in peripheral blood.This helps kill cancer cells that fell out during the surgery.

关 键 词：胃肿瘤 化学疗法 肿瘤 局部灌注 

分 类 号：R735.2[医药卫生—肿瘤]