胃癌根治切除并温热低渗液腹腔灌洗的疗效分析  

Curative effect of radical gastrectomy combined with peritoneal lavage with thermal hypoosmotic solution in treatment of gastric cancer

作　　者：陈峻青[1] 王舒宝[1] 徐惠绵[1] 刘庆华[1] 戴冬秋[1] 单吉贤[1] 梁洪伟[1] 

机构地区：[1]中国医科大学肿瘤研究所,沈阳110001

出　　处：《中华医学杂志》2001年第12期730-732,共3页National Medical Journal of China

基　　金：卫生部重大研究课题基金资助项目

摘　　要：目的　评价胃癌根治切除并用温热、低渗液或低渗液加洗必泰腹腔灌洗的疗效与适应证。方法　将 1986年 1月至 1995年 12月间施行胃癌根治切除术 5 0 0例患者分成 3组。A组 :根治术并用 43℃蒸馏水 40 0 0ml腹腔灌洗 10min ,共 198例 ;B组 :根治术并用 43℃蒸馏水 40 0 0ml+醋酸洗必泰 0 6g,腹腔灌洗 4min ,共 89例 ;C组 :根治术关腹前应用生理盐水 40 0 0ml,腹腔清洗 4min ,共 2 13例。结果　A组与B组疗效相同 ,二者合在一起计算称灌洗组。各期病例术后 1、3年生存率 3组间差异无显著意义 ;全组 5年生存率 ,灌洗组为 6 3 8% ,对照组为 5 1 2 %。而且有效病例多为灌洗组中期 (Ⅱ、ⅢA期 )病例。结论　胃癌根治术 ,关腹前采用本疗法行腹腔灌洗 ,对Ⅱ期。Objective To evaluate the curative effect and indications of radical gastrectomy combined with peritoneal lavage with theramal hypoosmotic solution, double distilled water (DDW) or DDW plus chlorhexidine acetate, in treatment of gastric cancer. Methods Five hundred cases of gastric cancer who underwent radical gastrectomy from January 1986 to December 1995 were divided into three groups: group A with 198 cases who underwent radical gastrectomy and peritoneal lavage for 10 minutes with 400 ml of DDW at 43℃, group B, with 89 cases who underwent radical gastrectomy and peritoneal lavage for ten minutes with 4 000 ml of DDW plus 0.6 g chlorhexidine acetate, and group C, with 213 cases who underwent radical gastrectorny and peritoneal lavage for four minutes with 4 000 ml of normal saline at normal temperature as controls. Results The group A and group B (called lavage group as a whole) had almost the same curative effects. The one year survival rates and three year survival rates were similar among the cases in different stages in no matter what group. The five year survival rate was 63.8% in the lavage group and 51.2% in the control group, most of the cases with a good effect being at the mid stage (Ⅱ and ⅢA stages). Conclusion Peritoneal lavage, helpful in killing the exfoliated cancer cells in peritoneal cavity of patients with gastric cancer at Ⅱ and ⅢA stages, should be conducted in the treatment of gastric cancer by radical gastrectomy before closing the abdomen.

关 键 词：胃肿瘤 胃切除术 腹膜灌洗法 温热 胃癌 低渗液 

分 类 号：R735.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]