低渗温热腹腔灌注化疗治疗恶性腹腔积液的临床研究  

Low permeability hyperthermic peritoneal perfusion chemotherapy in treatment of malignant peritoneal effusion

作　　者：孙贵富[1] 刘海英[1] 黄莉丽[1] 

机构地区：[1]海盐县人民医院肿瘤科,314300

出　　处：《浙江医学》2015年第4期324-326,共3页Zhejiang Medical Journal

基　　金：海盐县卫生局科技计划项目(2013WSYB009)

摘　　要：目的评价低渗温热腹腔灌注化疗治疗恶性腹腔积液的疗效及不良反应。方法行腹腔穿刺置单腔中心静脉导管。外接引流袋。记录腹水引流量，当日排放腹水1500ml后，予加热至43～45℃注射用双蒸馏水1000ml行腹腔灌注，次日重复放液1500ml，再予加热至43～45℃注射用双蒸馏水1000ml行腹腔灌注，并于灌注后腹腔注入顺铂60mg、氟尿嘧啶500mg并封管，治疗期间常规给予简单水化、对症止吐等治疗。结果31例恶性腹腔积液患者共完成低渗温热腹腔灌注化疗42周期。完全缓解7例，部分缓解15，稳定5例，进展4例，完全缓解＋部分缓解占70．97％。中位进展时间（TTP）3．6个月（2～9个月），中位生存期（MST）5．6个月。毒副反应以消化道反应为主。结论低渗温热腹腔灌注化疗治疗恶性腹腔积，在延长患者的生存期、提高生活质量方面效果较好，临床上可推荐应用。Objective To evaluate the efficacy and safety of low permeability hyperthermic peritoneal perfusion chemotherapy in treatment of malignant peritoneal effusion. Methods Thirty one patients with malignant peritoneal effusion were included in the study. A single-lumen central venous catheter was placed by abdominal puncture. After ascites was drained, 1000ml double distilled water of 43-45 ℃was injected into peritoneal cavity, followed by injection of cisplatin 60 mg and fluorouracil 500 mg peritoneally. Conventional treatment was given, including simple hydration and anti-nausea drugs. The treatment was repeated after a week if necessary. Results Forty two cycles were completed in 31 patients, among whom CR was in 7 cases, PR 15, SD 5 and PD 4 with a response rate （CR＋PR） of 71.0%. The median time of progression was 3.6 months （2-9 months）, the median overall survival was 5.6 months. Digestive tract reaction is the main toxic and side effects. Conclusion Low permeability hyperthermal peritoneal perfusion chemotherapy is effective in treatment of malignant peritoneal effusion.

关 键 词：低渗 温热 化学治疗 恶性腹腔积液 

分 类 号：R730.53[医药卫生—肿瘤]