草酸铂腹腔化疗时机的选择  

Optimal timing of intraperitoneal chemotherapy with oxaliplatin in rats after colonic anastomosis

作　　者：刘勇[1] 杨阳[2] 刘辉[3] 宋云骏 

机构地区：[1]保定市第一中心医院肿瘤内科,河北省保定市071000 [2]河北大学医学部河北省医学教育研究室,河北省保定市071000 [3]中国医学科学院&北京协和医学院基础医学研究所,北京市100730 [4]承德市肿瘤医院肿瘤外科,河北省承德市067000

出　　处：《世界华人消化杂志》2014年第17期2434-2438,共5页World Chinese Journal of Digestology

基　　金：保定市科学技术研究与发展基金资助项目;No.13ZF030~~

摘　　要：目的:观察草酸铂不同时间腹腔化疗对大鼠结肠吻合口愈合的影响,探讨最佳给药时机.方法:40只♂Wistar大鼠实施结肠切除+端端吻合,术后随机分为Control组(n=10)与A组(n=30).A组接受草酸铂25 mg/kg腹腔化疗,依据给药时间随机等分为3个亚组,即:A1组(3d)、A2组(5 d)和A3组(7 d).术后10 d通过腹腔黏连分级、吻合口破裂压、计算机图像软件测量组织形态参数等,评估各组大鼠肠管愈合质量.结果:40只大鼠均进入结果分析,无脱落.A1组大鼠腹腔黏连程度最严重,同A2组、A3组和Control组比较差异有统计学意义(P<0.05).A1组大鼠吻合口破裂压为103.90 mmHg±7.97 mmHg,而A2组、A3组和Control组吻合口强度显著提高,分别为167.10 mmHg±19.84 mmHg、178.20 mmHg±26.67 mmHg、184.10 mmHg±23.77 mmHg,差异有显著性意义(χ2=18.64,P=0.0001).组织形态测量结果显示:A1-3组与Control组黏膜下层厚度分别为82.40μm±9.66μm、91.50μm±8.74μm、96.00μm±7.85μm、95.40μm±8.95μm,肠肌层厚度分别为487.20μm±26.28μm、539.30μm±39.46μm、521.00μm±35.35μm、539.60μm±45.61μm.A2组、A3组和Control组在黏膜下层及肠肌层厚度方面优于A1组(F=5.05,P=0.0051;F=4.35,P=0.0103).Control组与A组的黏膜层厚度差别无显著性(χ2=7.324,P=0.0623).结论:结肠术后5 d草酸铂腹腔化疗安全、可行,对伴高危因素的结直肠癌患者术后早期腹腔化疗或许是最佳时机.AIM： To investigate the effect of intraperitoneal oxaliplatin administration at different times post- operatively on colonic wound healing in rats. METHODS： Forty male Wistar rats underwent end-to-end anastomosis after colonic transection and then were randomly assigned to receive in- traperitoneal administration of oxaliplatin or not as follows： group A （n = 30）, 25 mg/kg oxaliplat-in; control group （n = 10）. The former group was sub-divided into three equal subgroups （A1-3） and oxaliplatin was intra-abdominally injected postoperatively as follows： day 3 （A1）, day 5 （A2） and day 7 （A3）. Abdominal adhesion, anasto- motic bursting pressure and histomorphometric parameters were assessed on the postoperative day 10. RESULTS： All the rats survived throughout the experimental period. Group A1 presented a significantly higher extent of intra-abdominal adherences than the other groups （P 〈 0.05）. The bursting pressure was significantly lower in group A1 than in groups A2, A3 and control group （103.90 mmHg ± 7.97 mmHg vs 167.10 mmHg ± 19.84 mmHg, 178.20 mmHg ± 26.67 mmHg, 184.10 mmHg ± 23.77 mmHg; ）ca = 18.64, P = 0.0001）. The subrnucosal thickness in groups A1, A2, A3 and control group were 82.40 -tm ± 9.66 μm, 91.50 μm ± 8.74 μm, 96.00μm ± 7.85 μm and 95.40 μm ± 8.95 μm, respectively. The myenteron thickness in groups A1, A2, A3 and control group were 487.20 μm ± 26.28 μm, 539.30 μm ± 39.46 μm, 521.00 μm ± 35.35 μm and 539.60 μm ± 45.61 μm, respectively. The alterations in submucosal thickness and myenteron thickness were most pronounced in group A1, which were significantly decreased compared to the control group and groups A2 and A3 （F = 5.05, P =0.0051; F = 4.35, P = 0.0103）. There was no significant difference regarding mucosal thickness among the groups （P = 0.0623）. CONCLUSION： Intraperitoneal oxaliplatin administration is safe and feasible on postoperative day 5 after colonic resection, which may be an optimal time point for patie

关 键 词：有机铂类化合物 腹腔内注射 药物疗法 结直肠肿瘤 

分 类 号：R730.5[医药卫生—肿瘤]